KBB-Forum 2020 , Cilt 19, Sayı 2

ASSOCIATION OF LOCAL ANESTHETIC INJECTION TECHNIQUE WITH POSTOPERATIVE EDEMA AND ECCHYMOSIS IN PATIENTS UNDERGOING UPPER BLEPHAROPLASTY: SHARP-TIPPED NEEDLE VERSUS BLUNT-TIPPED CANNULA

Berke ÖZÜCER 1, MD; Hülya YÜKSEL 2, MD; Oğuz ÇÖRTÜK 3, MD; Ömer UYSAL 4, MD
1Başkent Üniversitesi, İstanbul Hastanesi, KBB Bölümü, İstanbul, Turkey
2Gaziosmanpaşa Taksim Eğitim Araştırma Hastanesi, Göz Bölümü, İstanbul, Turkey
3Gaziosmanpaşa Taksim Eğitim Araştırma Hastanesi, Plastik Cerrah Bölümü, İstanbul, Turkey
4Bezmialem Vakıf Üniversitesi, Biyoistatistik Bölümü, İstanbul, Turkey
Objective: Postoperative periorbital ecchymosis and edema following upper blepharoplasty is the most common morbidity that prolongs postoperative downtime and delays return to social life. Aim of this study was to evaluate the effect of local anesthetics injection technique on postoperative ecchymosis and edema. Local anesthetic injection with blunt-tipped cannula (BC) was compared with local anesthetic injection with sharp-tipped needle (SN).

Materials and Methods: Study was designed as a prospective comparative cohort trial without randomization. Sixteen patients who required upper blepharoplasty were randomly assigned to have one upper eyelid local anesthetic injection via BC and the other via SN prior to surgery. Content of local anesthetic and surgical interventions were otherwise identical for both eyes. Standardized postoperative frontal photographs were taken on first and seventh postoperative day for each patient. These photographs were graded with side-by-side comparison for ecchymosis and edema by three blinded surgeons. Each side was graded to the contralateral side for edema and ecchymosis seperately by three choices 1) right more than left 2) left more than left 3) no difference between sides.

Results: Thirthy-two upper eyelids of sixteen patients were operated. Mean age was 59.3±6.6. Ecchymosis grading results were similar for both BC and SN side, both for postoperative day 1 and 7. Edema grading results were also similar for both BC and SN side, both for postoperative day 1 and 7. There was statistically no improvement in BC side in comparison to SN side.

Conclusion: The utilization of blunt-tipped cannulas does not reduce ecchymosis and edema in the early postoperative period. Keywords : Blepharoplasty, ecchymosis, edema, bruising, cannula, blunt cannula