Evaluation of the effect of different bed head heights on edema, echymosis, respiratory function and sleep quality after rhinoplasty

This study was conducted to evaluate the effects of 30° and 45° bed head elevation given to patients after rhinoplasty surgery on periorbital edema and ecchymosis, respiratory function, and sleep quality. The study is a clinical study with a randomized controlled experimental design. The population of the study consisted of patients who underwent open rhinoplasty surgery between December 2022 and May 2023 in a state hospital located in northern Turkey. 60 patients were divided into experimental and control groups using randomizer.org. The experimental group was given a 45° bed head elevation, and the control group was given a 30° bed head elevation. Data were collected using the Data Collection Form, Edema and Ecchymosis Assessment Form, Richards-Campbell Sleep Quality Scale (RCUÖ) and Respiratory Assessment Form. SPSS 22.0 statistical program was used in the analysis of data. Differences between the proportions of categorical variables in independent groups were analyzed using the Chi-Square test. Independent groups t-test was used to compare quantitative continuous data between two independent groups. Dependent groups t-test, repeated measures ANOVA test and complementary Bonferroni test were used to compare within-group measurements. Informed consent, ethical permission and institutional permission were obtained from the patients to conduct the study. In the control group, the edema around the eyes at the 24th hour after surgery was determined to be higher than the 4th hour. While the edema around the eyes at the 1st hour after surgery did not show a significant difference in the patients in the experimental and control groups, it was determined that the edema around the eyes in the experimental group was lower than the control group at the 4th and 24th hours after surgery. The ecchymosis around the eyes in the experimental and control groups was determined to be higher at the 24th hour after surgery. The patients in the experimental and control groups did not show any significant difference in the 1st hour after surgery in terms of periorbital ecchymosis. The control group was found to have higher periorbital ecchymosis than the experimental group at the 4th and 24th hours after surgery. It was determined that there was no significant difference in respiratory rate measurements at the 1st, 4th and 24th hours after surgery between the experimental and control groups. While there was no significant difference in saturation measurements in the experimental and control groups at the 1st and 4th hours after surgery, the saturation value was determined to be higher in the experimental group than in the control group at the 24th hour after surgery. The participation of the accessory muscles in respiration did not show a significant difference between the experimental and control groups at the 1st hour after surgery. While there was participation of accessory muscles in respiration in 66.7% of the control group at the 4th hour after surgery, there was participation of accessory muscles in respiration in 20.0% of the experimental group. At 24 hours after surgery, 63.3% of the control group had respiratory accessory muscles, while 16.7% of the experimental group had respiratory accessory muscles. At 1, 4 and 24 hours after surgery, it was determined that the rate of breathing difficulties was higher in the control group than in the experimental group. At 24 hours after surgery, the rate of breathing difficulties was 70.0% in the control group, while this value was 20.0% in the experimental group. The groups showed significant differences in terms of respiratory quality at 1, 4 and 24 hours after surgery. At the 1st hour after surgery, hyperpnea was observed in the control group, while normal breathing was observed in the experimental group; at the 4th hour, tachypnea was observed in the control group, while normal breathing was observed in the experimental group; at the 24th hour, tachypnea and hyperpnea were observed in the control group, while normal breathing was observed in the experimental group. The sleep quality of the experimental and control groups did not differ significantly according to the groups. It was determined that the sleep quality of the patients in both groups was poor. The study showed that different bed head heights affected postoperative edema, ecchymosis and respiratory parameters in patients undergoing rhinoplasty surgery. It was determined that the edema and ecchymosis rate was lower in the experimental group patients than in the control group patients at the end of the 24th hour. It was observed that the given bed head height did not affect the sleep quality of the patients.