title: Occurrence of Bruise, Hematoma, and Pain in Upper Blepharoplasty Using Blunt-Needle vs Sharp-Needle Anesthetic Injection in Upper Blepharoplasty: A Randomized Clinical Trial.
abstract: OBJECTIVE
  Though it has been a common practice to use sharp needles to administer local anesthesia for upper blepharoplasty, the evidence for their benefit is lacking.
  
  
  OBJECTIVE
  To 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.
  
  
  METHODS
  Randomized 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.
  
  
  METHODS
  Visual 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.
  
  
  RESULTS
  In 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
  Use 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.
  
  
  METHODS
  1.
  
  
  BACKGROUND
  Chinese Clinical Trial Registry identifier: ChiCTR-ONC-16007979.
authors.affiliation: Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
authors.forename: Wenxin
authors.initials: W
authors.lastname: Yu
authors.affiliation: Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
authors.forename: Yunbo
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Jingyan
authors.initials: J
authors.lastname: Yang
authors.affiliation: Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Ma
authors.affiliation: Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
authors.forename: Yajing
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Yang
authors.affiliation: Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chang
authors.affiliation: Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Plastic and Reconstructive Surgery, Shanghai, China.
authors.forename: Xiaoxi
authors.initials: X
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019882:Blepharoplasty / Q000379:methods*; D004438:Ecchymosis / Q000209:etiology*; D004867:Equipment Design; D005260:Female; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine