Evidence, not habit.
Much of perioperative care is inherited habit. The group's double-blind randomized trial of gabapentin for sinus surgery measured what actually reduces pain and opioid consumption after FESS. A companion RCT asked the optimal pre-operative corticosteroid dose in polyp disease — enough to shrink inflammation, no more than needed.
A third line of trials studies virtual reality as distraction analgesia during awake, office-based procedures — directly relevant to the practice's in-office hybrid OR program, where patient comfort without general anesthesia is the entire premise.
Selected papers.
- Gabapentin and postoperative pain and opioid consumption: A double-blind randomized controlled trial of perioperative pain management for sinus surgery. American Journal of Otolaryngology, 2023. PubMed · DOI
- Seeking an optimal dose of preoperative corticosteroids in chronic rhinosinusitis with nasal polyposis: A randomized controlled trial. American Journal of Otolaryngology, 2022. PubMed
- Virtual Reality as Distraction Analgesia for Office-Based Procedures: A Randomized Crossover-Controlled Trial. Otolaryngology–Head and Neck Surgery, 2020. PubMed
- Factors Associated with High-Risk Ergonomic Postures During Office-based Rhinology Procedures: A Pilot Biomechanical Analyses. International Forum of Allergy & Rhinology, 2025. PubMed