Does Injection of Lidocaine with 1/100000 Epinephrine Immediately before Lateral Osteotomy Reduce Post-Operative Periorbital Edema and Ecchymosis in Rhinoplasty?
Background: Postoperative periorbital edema and ecchymosis are common after rhinoplasty. We studied the effect of local injection of Lidocaine/Adrenaline immediately before osteotomy on prevention of post-operative periorbital edema and ecchymosis in rhinoplasty.
Materials and Methods: Thirty healthy candidates for rhinoplasty were enrolled in the self-controlled clinical trial study. Lidocaine/Adrenaline solution injected randomly to one side just prior to the lateral osteotomy. The opposite side used as a control. The degree of edema/ecchymosis on both sides was compared on the 1st, 2nd and 7th day postoperatively.
Results: Mean of severity of edema, 24 hours after operation was 3in both sides, (Mann-whitney U; p=0.829). Mean of severity of edema, 48 hours after operation was 2 in both sides (Mann-whitney U; p=0.867) and it was 1 in both sides 7 days after operation (Mann-whitney U; p=0.756).There was no significant difference between two sides. Mean of severity of ecchymosis, 24 hours after operation was 3 in both sides (Mann-whitney U; p=0.692). Mean of severity of ecchymosis, 48 hours after operation was 2 in both sides (Mann-whitney U; p=0.655) and it was 1 in both sides 7 days after operation (Mann-whitney U; p=0.873). There was no significant difference between two sides.
Conclusion: local injection of Lidocaine/Adrenaline solution immediately before lateral osteotomy could not reduce postoperative edema and ecchymosis in rhinoplasty.
Ghazipour A, Akbari Dilmaghani N. Effect of Dexamethasone on Postoperative Periorbital Edema And Ecchymosis In Rhinoplasty. Iranian Journal Of Otorhinolaryngology. 2007.
Sarwer DB, Pertschuk MJ, Wadden TA, Whitaker LA. Psychological investigations in cosmetic surgery: A look back and a look ahead. Plastic and reconstructive surgery. 1998;101(4):1136-42.
Eloy JA, Jacobson AS, Elahi E, Shohet MR. Enophthalmos as a complication of rhinoplasty. The Laryngoscope. 2006;116(6):1035-8.
Hatef DA, Ellsworth WA, Allen JN, Bullocks JM, Hollier LH, Stal S. Perioperative Steroids for Minimizing Edema and Ecchymosis After Rhinoplasty A Meta-Analysis. Aesthetic Surgery Journal. 2011;31(6):648-57.
Rettinger G, Steininger H. Lipogranulomas as complications of septorhinoplasty. Archives of Otolaryngology–Head & Neck Surgery. 1997;123(8):809-14.
Lawson W, Kessler S, Biller HF. Unusual and fatal complications of rhinoplasty. Archives of Otolaryngology—Head & Neck Surgery. 1983;109(3):164.
Teichgraeber JF, Riley WB, Parks DH. Nasal surgery complications. Plastic and reconstructive surgery. 1990;85(4):527-31.
Goldfarb M, Gallups JM, Gerwin JM. Perforating osteotomies in rhinoplasty. Archives of Otolaryngology–Head & Neck Surgery. 1993;119(6):624-7.
Hoffmann DF, Cook TA, Quatela VC, Wang TD, Brownrigg PJ, Brummett RE. Steroids and rhinoplasty: a double-blind study. Archives of Otolaryngology–Head & Neck Surgery. 1991;117(9):990-3.
Gun R, Yorgancılar E, Yıldırım M, Bakır S, Topcu I, Akkus Z. Effects of lidocaine and adrenaline combination on postoperative edema and ecchymosis in rhinoplasty. International journal of oral and maxillofacial surgery. 2011;40(7):722-9.
Kalantar-Hormozi A, Fadaee-Naeeni A, Solaimanpour S, Mozaffari N, Yazdanshenas H, Bazargan-Hejazi S. Can Elimination of Epinephrine in Rhinoplasty Reduce the Side Effects: Introduction of a New Technique. Aesthetic plastic surgery. 2011;35(4):582-7.
Available from the address: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=49391.
Kargi E, Hosnuter M, Babucçu O, Altunkaya H, Altinyazar C. Effect of steroids on edema, ecchymosis, and intraoperative bleeding in rhinoplasty. Annals of plastic surgery. 2003;51(6):570-4.