• Wenxin Yu, Yunbo Jin, Jingyan Yang, Gang Ma, Yajing Qiu, Hui Chen, Xi Yang, Lei Chang, and Xiaoxi Lin.
• Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
• JAMA Facial Plast Surg. 2017 Mar 1; 19 (2): 128-132.

ImportanceThough it has been a common practice to use sharp needles to administer local anesthesia for upper blepharoplasty, the evidence for their benefit is lacking.ObjectiveTo evaluate whether there is any benefit of using blunt-needle injection for local anesthesia when performing upper blepharoplasty to reduce postoperative bruise, hematoma, and pain.Design, Setting, And ParticipantsRandomized clinical trial of 44 patients who underwent bilateral upper blepharoplasty in an academic medical setting were randomized to receive local anesthesia injections (lidocaine, 2%; 27-gauge needle) with a blunt needle in one eyelid and a sharp needle in the other eyelid.Main Outcomes And MeasuresVisual analog scale (VAS) score of 0 to 10 (lower score indicating lower level of pain) was used to blindly assess pain in patients receiving anesthesia injections with both needle types. After injection and skin incision, photographs of the eyelids of each patient were taken and used by 2 blinded observers to identify bruise or hematoma.ResultsIn the 44 patients (88 eyelids) included in the study (all women; mean age, 31 years; age range, 18-56 years) bruise or hematoma occurred at the sharp-needle injection site in 11 women (25%) vs 0 women at the blunt-needle site (P < .001). The mean VAS scores were 5.48 and 4.64 for pain assessed at sites of sharp- and blunt-needle injections, respectively (P = .002).Conclusions And RelevanceUse of blunt needles to administer local anesthesia when performing upper blepharoplasty is less likely to cause hemorrhage and require interventional pain procedures than use of sharp needles. Therefore, for a more accurate surgical procedure and faster recovery, a blunt needle may be a preferable choice. The use of the blunt needle presents fewer complications and allows more accurate and refined work with faster patient recovery.Level Of Evidence1.Trial RegistrationChinese Clinical Trial Registry identifier: ChiCTR-ONC-16007979.

22 keywords...

hide…