Preparation In The Operating Room Before The Rhinoplasty Operation

Preparation For Nose Aesthetic Surgery Just Before The Operation

Before the rhinoplasty operation, different preparations such as cleaning the operation area, intranasal cleaning, local anesthetic injection, anesthesia preparation are made.

Anesthesia preparation and general anesthesia

Before the general anesthesia of the patients, an intubation tube is inserted into the trachea by intravenous and respiratory tract after various drugs are administered. Usually this tube is placed in the midline and detected. It is important to keep the blood pressure low, not to increase the carbon dioxide level, and to use long-acting corticosteroids in the rhinoplasty operation. Generally, it is important that patients are awakened slowly and blood pressure is not increased while being awakened after the operation.

Cleaning the nose area with antiseptic products

Generally, there are many bacteria and microorganisms in the nose. It is important to pay attention to sterilization and cleaning conditions as much as possible. It is important to wipe the nose area with antiseptic products and disinfect the nose area in the same way.

Cutting nasal hair

Before the rhinoplasty operation, most surgeons shave their intranasal hair. Small angle scissors or scalpel can be used for this.

Injection of local anesthetic under the skin of the nose

After the nose hair is cut, local anesthetic infiltration is required to different areas of the nose and incision areas. Generally, mixtures containing adrenaline + lidocaine and products containing prilocaine or bupivakain can be used. In particular, performing local anesthetic infiltration at least 30 minutes before the nose operation is effective in reducing bleeding during the operation and pain after the operation.

Cold sterile serum application on the nose

I usually apply this to every patient. The opinions of other physicians may differ on this issue, but I apply the cold serum obtained by mixing the sterile serum frozen at minus 10-30 degrees with the normal temperature cream on the nose with sterile gauze before the operation. Usually, we start the operation immediately after the infiltration of the local anesthetic, by applying local cold on the nose and covering the patient with sterile covers within 30 minutes.

Covering the patient with sterile covers

At this stage, all areas of the patient, except the hair, neck and face of the body, are covered with sterile covers, with the entire facial area of ​​the patient open.

Changing the patient's bed position

Usually the rhinoplasty position is as follows:

- The upper half of the patient should be in a semi-vertical position at an angle of 45 degrees from the lower half. In this way, the blood pressure in the head area decreases and the surgeon has a better command of the nasal anatomy.

Preparation of sterile serum with antibiotics

This stage may also vary according to different clinics. During the operation, we prepare a mixture of rifampicin and sterile serum and wash the nose with this mixture at regular intervals.

Selection and preparation of surgical instruments

Just before the rhinoplasty operation, the aesthetic nose surgery surgical instruments, which every surgeon frequently uses, are lined up on the sterile covered operating table. The sterilization conditions of the hospital environment and the sterilization of these instruments are very important. There are different surgical instruments that vary according to the techniques and methods used by physicians. Generally, the most variable is the instrument used for cutting the nasal bone, as well as roughly breaking it. Piezo ultrasonic device, tour motor, specially designed lateral osteotomy instruments can be used. I usually apply the bone cutting technique by opening microtunnels on both sides of the nasal bone, and then I soak special compressed cotton balls with anti-bleeding solutions and keep them in this tunnel upright.

I wish you good luck in your operation.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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