Positive End-Expiratory Pressure in Rhinoplasty Surgery; Risks and Benefits.

[AIMS] The aim of this study is to evaluate the effect of Positive End Expiratory Pressure (PEEP) on surgical field bleeding and its respiratory and hemodynamic consequences in rhinoplasty surgeries.

[MATERIALS AND METHODS] This single-blind clinical trial performed in Amir Al-Momenin university Hospital in 2018. Seventy cases of rhinoplasty surgery patients Enrolled and were randomized into two groups; intervention (PEEP = 5) and comparison group (PEEP = 0). Surgical field bleeding and arterial oxygen saturation pulmonary dynamics and hemodynamic parameters were evaluated during operation and in post anesthesia care unit. Data were analyzed by SPSS software using descriptive and analytical statistics.

[RESULTS] PEEP applying had no negative effect on surgical bleeding as well as surgeon satisfaction, heart rate and blood pressure were similar in two groups. Pulmonary dynamics and oxygenation were stable and within normal values in all cases. The mean peak airway pressure was 17.87 ± 2.24 in the PEEP group and 16.08 ± 3.37 in the ZEEP group (P = 0.029).

[CONCLUSION] applying low level PEEP during anesthesia improved recovery oxygen saturation but had no negative effects on the patient`s hemodynamics, and did not aggravate bleeding and visual clarity.

[SUPPLEMENTARY INFORMATION] The online version contains supplementary material available at 10.1007/s12070-023-03854-7.