Pre-op Meds: Ancef or clindamycin, decadron 8mg

Anesthesia:  general

Patient position: supine

Bed position: 90° right side of patient facing towards surgeon left side of patient facing towards anesthesia

DVT ppx:  compression boots on and working BEFORE induction of anesthesia

Side Table:  prep table includes 10 mL 1% lidocaine 1/100 K epinephrine 27gauge needle, speculum, packing forceps, six nasal pledges soaked in cocaine, scissors

Lights: headlight for surgeon

Power: nine

Bovie Setting:  10 – 10, Colorado tip

Preinjection: done before prepping, see side  table

Prep: Betadine

Drapes: four towels and a split sheet

Instrument sets:  Tebbets rhinoplasty set,  septoplasty  set


Special Instruments:  carving block, carving grid, graft templates, and  dorsal nasal sizers


Devices/Implants: none

Hypodermic needles: 27gauge

Syringes: 10 mL syringe with 1% lidocaine 1/100 K epinephrine

Drains: none

Suture: 5-0 PDS undyed cutting small needle, 6-0 prolene taper, 4-0 plain gut straight needle, 5-0 chromic RB-1

Anesthesia on field: 10 cc  1% lidocaine 1/100 K epinephrine

Dressing: benzoin and half-inch Steri-Strips to be cut by surgeon

Admission status: SDS

Estimated time: two hours

Coding:ICD-9 478.19, 470.0, 905.0  CPT-ask surgeon

Post-op wound care:  minimize nose blowing, knees with open mouth, drip pads for bleeding.

Post-op activity restirctions:  No vigorous activity for two weeks

Follow up:  one week