Perioperative pain management in rhinology and anterior skull base surgery

Endoscopic sinus and skull base surgeries allow for minimally invasive surgical management of inflammatory, benign, and malignant pathologies involving the nose, paranasal sinuses, and medial skull base. Although minimally invasive, endoscopic sinus and skull base surgeries are not painless, and it is important that surgeons are aware of pain management strategies for this patient population. While opioids do provide one option for pain control, there are many preemptive options that can be utilized to reduce the severity of postoperative pain. There are also many opioid-sparing options that can be utilized to improve pain control after surgery. These strategies should be used in a multimodal fashion for optimal pain control after surgery.