Effect of an Enhanced Recovery after Surgery Protocol in Postoperative Pain and Opioid Consumption after Rhinoplasty.

BACKGROUND: Enhanced recovery after surgery (ERAS) protocols reduce opioid exposure in many surgical fields, but their impact on rhinoplasty has not been studied. OBJECTIVE: To compare postoperative pain control and opioid use during the first week after open septorhinoplasty among patients treated with a traditional hydrocodone/oxycodone and patients treated in an ERAS pathway, as measured by patient-reported pain score and opioid use. METHODS: Retrospective cohort study of open septorhinoplasty patients before and after ERAS implementation. Cohort I received hydrocodone/oxycodone with nonstandardized perioperative management. Cohort II followed a standardized ERAS pathway with tramadol, Celebrex, prednisone, and acetaminophen. Pain scores and opioid consumption were compared. RESULTS: = 0.51). CONCLUSION: A multi-modality ERAS protocol after open septorhinoplasty reduced postoperative pain during the first week after surgery, without increasing opioid usage, compared to traditional pain management with opioids.