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Blunt needles deliver less pain, bruises for anaesthesia delivery in upper blepharoplasty

Tristan Manalac
25 Aug 2017

Using blunt needles to administer local anaesthesia in upper blepharoplasty has a lower risk of haemorrhage and need for interventional pain procedures compared with sharp needles, a new randomized clinical trial has found.

“To our knowledge, this is the first prospective, side-by-side comparison study revealing that the use of a blunt needle for local anaesthesia injections in upper blepharoplasty is associated with a lower level of pain and a lower incidence of bruise and/or haematoma,” said researchers.

“This indicates that the use of blunt needles can minimize patient discomfort and allow for greater surgical precision when performing the upper blepharoplasty procedure and thus lead to fewer complications and faster recovery,” they added.

The study included 44 patients (mean age 31 years) about to undergo bilateral upper blepharoplasty at the Shanghai Ninth People’s Hospital. Local anaesthesia was delivered using a blunt needle to the patients’ eyelids and a sharp needle to the other.

The visual analogue scale (VAS) was used to determine pain from the anaesthesia injection, while photographic evaluation was used to determine the difference in the degree of bruising and haematoma between the eyes.

The mean VAS scores for the sharp and blunt needles were 5.48±1.59 (95 percent CI, 4.99 to 5.96) and 4.64±1.67 (4.13 to 5.14), respectively. The difference reached statistical significance p=0.002), indicating that blunt needles resulted in less pain than sharp needles. [JAMA Facial Plas Surg 2017;19:128-132]

“Blunt needles have been considered easier to use and less likely than sharp ones to produce bleeding because of inadvertent penetration of arteries or adjacent vital structures,” explained researchers.

“Accordingly, blunt needles are used to reduce the complications resulting from the use of sharp ones, which include bleeding, bruising, blood vessel impalement and subsequent intravascular injection and haemorrhage,” they continued.

Indeed, none of the eyelids treated with blunt needles developed bruises, while 25 percent (n=11) of the eyelids injected using sharp needles developed bruises. The difference in occurrence reached statistical significance (p<0.001).

This “indicates that blunt needles may reduce the incidence of bruise and haematoma in upper blepharoplasty compared with sharp needles,” according to researchers. The findings are consistent with previous studies that have shown fewer complications from blunt needles.

“[B]lunt needles may reduce the entry into vital structures and reduce the occurrence of hemorrhage and haematoma. In addition, blunt needles may be more beneficial for performing interventional pain procedures than sharp needles,” researchers noted.

“Therefore, the use of blunt needles has the potential to become a conventional application to reduce the complications during the administration of local anaesthesia injection in upper blepharoplasty and lead to a faster recovery,” they added.

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