Preoperative Desmopressin for Bleeding Reduction During Rhinoplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

[BACKGROUND] Bleeding is a primary complication associated with rhinoplasty. The hemostatic effect of Desmopressin (DDAVP) in enhancing coagulation factors is being studied to prevent this complication in rhinoplasty patients.

[METHODS] We performed a systematic review and meta-analysis of randomized clinical trials (RCTs) analyzing the effects of preoperative DDAVP during rhinoplasty. The outcomes evaluated were intraoperative bleeding and the quality of the surgical field.

[RESULTS] Four studies comprising 262 rhinoplasty patients were included. Preoperative administration of intranasal DDAVP was associated with a significant reduction in total blood loss (MD = - 15.22 mL; 95% CI - 19.52 to - 10.93; p < 0.00001; I = 0%). Independent analyses also reported a significant improvement in the quality of the surgical field.

[CONCLUSION] DDAVP resulted in a statistically significant reduction in bleeding and a drier surgical field. However, the clinical significance remains to be established and further studies are required.

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