Purpose: The timing, schedule, and doses of dexamethasone administration to control edema are a topic of debate. This prospective observational study was performed to evaluate the effects of perioperative and intraoperative administration of dexamethasone on the occurrence of edema in patients who underwent rhinoplasty. Methods: This study was conducted at Najran University Hospital, Najran University, Saudi Arabia, from June 2019 to August 2020. Seventy-five patients who underwent open rhinoplasty were assigned using a consecutive non-random sampling method into three groups, with 25 patients in each group. Group A patients received three doses of intravenous 8 mg dexamethasone perioperatively, and group B patients received a single dose of intravenous 8 mg dexamethasone intraoperatively. Group C patients received intravenous 2 mL of 0.9% normal saline solution intraoperatively and were considered as a control group. Digital photographs of patients were obtained and assessed on the 1st, 7th, and 14th days post-operatively. Results: The mean duration of operation was comparable between the studied groups (p = 0.368). On comparing the studied groups, significant differences in the edema scores were observed on the 1st and 7th day post-operatively (p < 0.001 for both), but not on the 14th day (p = 0.079). When comparing each group against the postoperative day of evaluation, statistically significant differences were detected between the 1st vs. 7th day and 1st vs. 14th day in Group A, whereas, in the other groups, no significant difference was detected (all p > 0.05). No Dexamethasone-related complications were observed. Conclusion: Dexamethasone significantly reduced periorbital swelling and edema after rhinoplasty compared to the control group. A short course of triple dose perioperative administration of dexamethasone is more potent in reducing edema from 1st to 7th day postoperative than a single dose intraoperatively.
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