Anesthesia using microcannula and sharp needle in upper blepharoplasty: A randomized, double-blind clinical trial evaluating pain, bruising, and ecchymoses

Garcia, Caio Pundek; Avila, Diego Fernando Villagra; Ferreira, Veralucia R.; Silva, F.C. da; Fortkamp, M.M. de S.; Gomes, Raísa; Ely, Jorge Bins

doi:10.1016/j.bjps.2020.08.015

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…As an important tool, regarding ultrasound thermal or mechanical safety, the for LA administration in soft tissues [24]. In 2020, Garcia and cols demonstrated that the utilization of an 18 G blunt canula was associated with a lower pain score during LA administration, and was non-inferior to a 26 G needle regarding hemorrhagic events [25]. The present study presents a safe utilization of a 25 G × 38 mm blunt canula.…”

Section: Discussionmentioning

confidence: 61%

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Ultrasound-Guided Peribulbar Block with Blunt Canula for Cataract Surgery: A Review of Historical Case-Series

Siqueira¹,

Siqueira²,

Lima³

et al. 2022

OJOph

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Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on patients' needs, surgeons' preferences and institutional facilities and processes. Although being more invasive than topic anesthesia, and with possible hazardous side effects, peribulbar block is still an effective and successful technique. The utilization of blunt canula and ultrasound guidance might enhance the safety pattern for this technique. Methods: This article presents a revision of 1089 consecutive cases from February 2016 to January 2022, of patients submitted to cataract surgery under peribulbar anesthesia with blunt canula and ultrasound guidance. Results: 1318 surgical records were selected, with 1089 filling the inclusion criteria. There was a higher prevalence of the feminine gender (54%), with a median age of 64.3 (28 -102) years. Mean IAV was 2.9 mL (sd 0.16 mL, 2.5 -3.0 mL), with total HOS 91.1%; OR to reach G2 or above for each (ISB/IMB) was 11.0; CA was 47.9%, with mean FAV of 4.29 mL (sd 2.17mL, 2.5 -15 mL). In 8.9% patients, HOS could not be fully observed. ISB, IMB, CA and FAV were calculated for both groups (non-HOS and HOS-only). OR for CA (non-HOS/HOS-only) was 126.21. The main adverse effects were chemosis (2.9%), hyposphagma (5.7%) and high IOP (7.5%).No procedure was postponed due to anesthesia-associated adverse events. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.

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Section: Discussionmentioning

confidence: 61%

“…The main adverse effects were chemosis (2.9%) and hyposphagma (5.7%). Chemosis were most observed after inferior-temporal infusion (90.6%), and hyposphagma was graduated in mild (restricted to injection site, 69.8%), moderate (reached anterior midline of the eye, 25…”

Section: Resultsmentioning

confidence: 99%

Ultrasound-Guided Peribulbar Block with Blunt Canula for Cataract Surgery: A Review of Historical Case-Series

Siqueira¹,

Siqueira²,

Lima³

et al. 2022

OJOph

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“…A sharp needle makes a skin hole entry site through which you pass a blunt-tipped cannula, which painlessly glides between nerves and blood vessels through subcutaneous fat to anesthetizing large areas more rapidly in procedures such as forearm tendon transfers, skin graft harvest from the thigh, and rhytidectomy. [48][49][50][51]12). When injecting 200 ml for a forearm tendon transfer or a rhytidectomy, inject the solution from an IV bag with tubing hooked up to a three-way stopcock and a 10-ml syringe.…”

Section: Use Blunt-tipped Cannulas When Tumescing Large Areasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How to Minimize the Pain of Local Anesthetic Injection for Wide Awake Surgery

Joukhadar

Lalonde

2021

Plastic and Reconstructive Surgery - Global Open

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After reading this article, the participant should be able to (1) almost painlessly inject tumescent local anesthesia to anesthetize small or large parts of the body, (2) improve surgical safety by eliminating the need for unnecessary sedation in patients with multiple medical comorbidities, and (3) convert many limb and face operations to wide awake surgery. We recommend the following 13 tips to minimize the pain of local anesthesia injection: (1) buffer local anesthetic with sodium bicarbonate; (2) use smaller 27-or 30-gauge needles; (3) immobilize the syringe with two hands and have your thumb ready on the plunger before inserting the needle; (4) use more than one type of sensory noise when inserting needles into the skin; (5) try to insert the needle at 90 degrees; (6) do not inject in the dermis, but in the fat just below it; (7) inject at least 2 ml slowly just under the dermis before moving the needle at all and inject all local anesthetic slowly when you start to advance the needle; (8) never advance sharp needle tips anywhere that is not yet numb; (9) always inject from proximal to distal relative to nerves; (10) use blunt-tipped cannulas when tumescing large areas; (11) only reinsert needles into skin that is already numb when injecting large areas; (12) always ask patients to tell you every time they feel pain during the whole injection process so that you can score yourself and improve with each injection; (13) always inject too much volume instead of not enough volume to eliminate surgery pain and the need for "top ups." (

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