Occurrence of Bruise, Hematoma, and Pain in Upper Blepharoplasty Using Blunt-Needle vs Sharp-Needle Anesthetic Injection in Upper Blepharoplasty

Yu, Wenxin; Jin, Yunbo; Yang, Jingyan; Ma, Gang; Qiu, Yajing; Chen, Hui; Yang, Xi; Chang, Lei; Lin, Xiaoxi

doi:10.1001/jamafacial.2016.1376

Cited by 19 publications

(27 citation statements)

References 10 publications

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“…Tumescent anesthesia for the buccal cortex is given with a blunt needle (Whitacre spinal, pencil pointed needle 25 GA, 3.50 in 0.5 mm × 90 mm) to minimize bruising and hematomas (Level III OCEBM). [ 51 ]…”

Section: R Esultsmentioning

confidence: 99%

Fast-track orthognathic surgery: An evidence-based review

Otero

Detriche

Mommaerts

2017

Ann Maxillofac Surg

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The aim of this study was to establish a fast-track protocol for bimaxillary orthognathic surgery (OGS). Fast-track surgery (FTS) is a multidisciplinary approach where the pre-, intra-, and postoperative management is focusing maximally on a quick patient recovery and early discharge. To enable this, the patients’ presurgical stress and postsurgical discomfort should be maximally reduced. Both referral patterns and expenses within the health-care system are positively influenced by FTS. University hospital-literature review through Medline, Embase, and the Cochrane Library (January 2000–July 2016) using the following words – “fast track, enhanced recovery, multimodal, and perioperative care” – to define a protocol evidence based for OGS, as well as evidenced-based medicine search of every term added to the protocol during the same period. The process has resulted in an OGS protocol that may improve the outcome of the patient through several nonoperative and operative measures such as preoperative patient education and intra/postoperative measures that should improve overall patient satisfaction, decrease morbidity such as postoperative nausea, headache, dizziness, pain, and intubation discomfort, and shorten hospital stay. A literature review allowed us to fine-tune a fast-track protocol for uncomplicated OGS that can be prospectively studied against currently applied ones.

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Section: R Esultsmentioning

confidence: 99%

Fast-track orthognathic surgery: An evidence-based review

Otero

Detriche

Mommaerts

2017

Ann Maxillofac Surg

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“…3-5 14 In general, it is recommended to use small diameter needles and to slowly inject the anaesthetic agent to reduce pain during the procedure. [15][16][17][18][19][20][21] Furthermore, various studies have reported factors that help minimise pain during local anaesthesia, which include the choice of the anaesthetic agent, dilution, buffering, and skin cooling. 22 Anaesthetic injections can also lead to tissue distortion and bleeding, which further distort the anatomical structures, making it more di cult to perform surgery accurately; thus, care should be taken to limit these.…”

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confidence: 99%

“…3 4 21 Various studies have been conducted to nd factors that reduce the pain of anaesthetic injections. 21 22 However, only one study has examined the difference in pain caused by the type of needle. 21 22 Yu et al reported that using 27-gauge blunt needles reduces pain and hematoma occurrence compared to using a 27-gauge conventional sharp needle during anaesthesia for upper blepharoplasty.…”

mentioning

confidence: 99%

“…21 22 However, only one study has examined the difference in pain caused by the type of needle. 21 22 Yu et al reported that using 27-gauge blunt needles reduces pain and hematoma occurrence compared to using a 27-gauge conventional sharp needle during anaesthesia for upper blepharoplasty. 21 This type of blunt needle has been introduced in some limited areas, such as interventional radiology, to avoid inadvertent penetration of vital structures, but it is not yet widely used in eyelid surgery.…”

mentioning

confidence: 99%

“…21 22 Yu et al reported that using 27-gauge blunt needles reduces pain and hematoma occurrence compared to using a 27-gauge conventional sharp needle during anaesthesia for upper blepharoplasty. 21 This type of blunt needle has been introduced in some limited areas, such as interventional radiology, to avoid inadvertent penetration of vital structures, but it is not yet widely used in eyelid surgery. 15 In contrast, insulin syringes, used primarily in the treatment to control blood glucose levels in diabetes management, are readily available.…”

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confidence: 99%

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Insulin syringe for anaesthetic injection in ptosis surgery: A randomised controlled clinical study

Song¹,

Lee²,

Choi³

2021

Preprint

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Background: To evaluate the potential benefit of using insulin syringes for local anaesthesia in ptosis surgery.Methods: Sixty patients (120 eyelids) were included in this randomised, fellow eye-controlled study at a university‐based hospital. An insulin syringe was used on one eyelid and a conventional 30-gauge needle on the other. Patients were asked to score pain in both eyelids using a visual analogue scale (VAS) ranging from 0 (no pain at all) to 10 (unbearable pain). Ten minutes after the injection, an observer scored the degree of haemorrhage and oedema in both eyelids on a scale of 0 to 4.Results: The VAS score was 5.17 in the insulin syringe group and 5.35 in the 30-gauge needle group (p=0.264). Ten minutes after the anaesthesia, the haemorrhage score was 1.30 and 1.64 and eyelid oedema score was 1.50 and 1.80 in the insulin syringe and 30-gauge needle groups, respectively (haemorrhage, p=0.045; eyelid oedema, p=0.023). Conclusion: Injecting local anaesthesia using an insulin syringe, compared to conventional 30-gauge needles, significantly reduces haemorrhage and eyelid oedema before skin incision but does not significantly reduce the injection pain. Using insulin syringes also presents fewer complications related to tissue penetration and lesser distortion of anatomical structures compared to conventional 30-gauge needles. We recommend using an insulin syringe for local anaesthesia in ptosis surgery.Trial registration: registry – CRIS / registration number – KCT0005120 / date of registration: 12/06/2020 (retrospectively registered), https://cris.nih.go.kr/cris/index.jsp

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2017

JAMA Facial Plast Surg

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Discussion | The ability to perform multiple cosmetic procedures simultaneously in the operating room without sacrificing safety or quality provides several benefits to both the patient and the surgeon. For the patient, it allows for limited anesthetic exposure, overlap of recovery times, and expedited results. For the surgeon, increased efficiency and improved patient experience both lend themselves to a more successful practice.Prior cadaveric studies by Rohrich et al 3 and Toriumi et al 4 have demonstrated the robust blood supply to the nasal tip and safety of performing a transcolumellar incision in open rhinoplasty. Further studies by Bafaqeeh and Al-Qattan 5 and Tellioğlu et al 6 reported on the safety of performing simultaneous open rhinoplasty and alar base excision.The studies by Bafaqeeh and Al-Qattan and by Tellioğlu and colleagues are important in demonstrating the redundancy of blood flow to the nasal tip and columella; however, neither of these studies can be reliably extrapolated to the safety of performing simultaneous lip-lift and rhinoplasty. The difference is that in alar base excision, the base of the columella is not incised as it is in the lip-lift incision. The lip-lift and open rhinoplasty incisions leave only a small island of columellar skin that is not contiguous with any other cutaneous skin. Our study shows that there is clearly redundant blood supply to the columella that is derived from the deeper attachments and not just the subdermal arterial plexus.Based on our findings, we conclude that lip-lift and open rhinoplasty can be performed safely through 2 separate columellar incisions without risk of skin necrosis or excessive scarring.

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Occurrence of Bruise, Hematoma, and Pain in Upper Blepharoplasty Using Blunt-Needle vs Sharp-Needle Anesthetic Injection in Upper Blepharoplasty

Cited by 19 publications

References 10 publications

Fast-track orthognathic surgery: An evidence-based review

Fast-track orthognathic surgery: An evidence-based review

Insulin syringe for anaesthetic injection in ptosis surgery: A randomised controlled clinical study

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