Effect of Intraoperative Ice Pack Application on Postoperative Pain, Edema, and Ecchymosis in Rhinoplasty: A Randomized Controlled Trial

Background: Pain, periorbital edema, and ecchymosis are common after rhinoplasty. Intraoperative ice pack application may reduce these sequelae. Objective: To compare 5- and 10-min intraoperative ice pack application with no intraoperative cooling after rhinoplasty. Methods: Thirty-three patients undergoing primary reduction rhinoplasty were randomized to 5-min ice pack application (Group A, n = 11), 10-min ice pack application (Group B, n = 11), or no intraoperative ice pack application (Group C, n = 11). Periorbital edema (0–4), ecchymosis (0–5), and pain (0–10 VAS) were assessed on postoperative days 1, 3, and 7. Results: Pain scores were lower in both ice pack application groups than in the control group on postoperative days 1 (Group A: 4.46 ± 0.72; Group B: 3.96 ± 0.85; Group C: 5.46 ± 0.93; p = 0.003) and 3 (Group A: 3.82 ± 0.56; Group B: 3.41 ± 0.86; Group C: 5.09 ± 0.63; p < 0.001). Edema did not differ among groups on days 1 or 3 but was lower in Groups A and B on day 7 (Group A: 0.09 ± 0.25; Group B: 0.09 ± 0.29; Group C: 0.36 ± 0.47; p = 0.019). Ecchymosis did not differ among groups at any time point. Conclusions: Intraoperative ice pack application was associated with lower pain scores after rhinoplasty. No significant reduction in ecchymosis was observed, and the effect on edema was limited.