Everything You Should Know About Rhinoplasty In-Patient Management

1. Preoperative preparation
2. Anesthesia and sedation
3. Immediate postoperative care

1. Preoperative preparation of the patient
   • Patient is admitted to the day case surgical center or to the hospital at 7 a.m.
   • Patient receives clinical examination by the admitting doctor and nurse.
   • Patient with his preoperative investigations reviewed by the anesthetist at 8:30 a.m.
   • Premedication’s are given. (p. 56)
   • Decongestant nose drops and Emla cream (Lidocaine) applied to the nose one hour pre surgery.
   • Zinacef 1.5mg (Cefuroxim) IV give one hour pre surgery.
2. Anesthesia and sedation: It has been fully explained in the chapter on local anaesthesia.
3. Immediate postoperative care

• The patient is kept in a semi-sitting position, 30° with head elevated.
• Ice pack applied to the forehead.
• Sedation and pain killers are considered to avoid excessive movement.
• Zinacef 1.5mg (Cefuroxim) every twelve hours.
• Voltaren (Diclofenac) 75mg. intramuscular every twenty four hours.
• Panadol two tablets every eight hours.
• 5% Dextrose IV every eight hours.
• Patient’s nasal packs are removed about 7 p.m. and then one hour later is discharged home on the following medicines:
  
  • Zinnat (Cefuroxim) 500mg _ one capsule every twelve hours for seven days.
  • Panadol two tablets every eight hours.
  • Normal saline drops _ four drops in each nostril every two hours during daytime.
  • Fucidin (Sodium Fusidate) ointment to be used on cotton tip applicator to paint the marginal incision and alar wedge incision.
• The above prescription and the use of ointment and nose drops are explained fully to the patient by our staff nurse.
• Postoperative instructions are read to the patient by our staff nurse and asked to follow strictly. A follow-up appointment is given in the clinic after seven days.