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Blunt needles preferable to avoid pain, bruising in upper blepharoplasty

Using blunt needles to administer local anesthesia during upper blepharoplasty procedures showed lower occurrence of pain and hemorrhage, according to study results published in JAMA Facial Plastic Surgery.

Forty-four patients planning to undergo primary upper blepharoplasty were recruited for the study between October 2014 and October 2015. All patients were Asian and female with a mean age of 31 years (range, 18-56).

The patients were treated prior to operation with local anesthesia (lidocaine, 2%). One eyelid was injected using a blunt needle (27-gauge, 50 mm long), while the other was injected using a sharp needle (27-gauge, 35 mm long).

The patients were instructed to score pain in each eyelid, without knowing which needle was used in which, by using a visual analog scale (VAS) with a range of zero (no pain at all) to 10 (unbearable pain).

The mean VAS pain score for sharp needles was 5.48 ± 1.59 (P = .002; 95% CI, 4.99-5.96), while the mean score for blunt needles was 4.64 ± 1.64 (P = .002; 95% CI, 4.13-5.14).

The researchers evaluated occurrence of bruise and/or hematoma by direct visualization and review of photographs. Bruising and/or hematoma occurred in 11 (25%) eyelids treated with sharp needles, whereas none of the eyelids treated with the blunt needle showed bruising or hematoma (P < .001; 95% CI, 1.12-1.58).

“The results indicate that blunt needles may reduce the entry into vital structures and reduce the occurrence of hemorrhage and hematoma,” the researchers wrote. “In addition, blunt needles may be more beneficial for performing interventional pain procedures than sharp needles.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.