Effects of lidocaine and adrenaline combination on postoperative edema and ecchymosis in rhinoplasty

• Published in: International journal of oral and maxillofacial surgery 2011-07, Vol.40 (7), p.722-729
• Main Authors: Gun, R, Yorgancılar, E, Yıldırım, M, Bakır, S, Topcu, I, Akkus, Z
• Format: Article
• Language: English
• Subjects: adrenaline; Adult; Anesthetics, Local - administration & dosage; Antiarythmic agents; Biological and medical sciences; Blood Loss, Surgical - prevention & control; Blood Pressure - drug effects; Cardiovascular system; Dentistry; ecchymosis; Ecchymosis - classification; Ecchymosis - etiology; edema; Edema - classification; Edema - etiology; Epinephrine - administration & dosage; Eyelid Diseases - classification; Eyelid Diseases - etiology; Female; Follow-Up Studies; Humans; Intraoperative Care; lidocaine; Lidocaine - administration & dosage; Male; Medical sciences; Osteotomy - methods; Otorhinolaryngology. Stomatology; Pain, Postoperative - prevention & control; Pharmacology. Drug treatments; Postoperative Complications; rhinoplasty; Rhinoplasty - methods; Surgery; Time Factors; Vasoconstrictor Agents - administration & dosage; Young Adult
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2011.02.022

Abstract Nasal osteotomies are the most important cause of periorbital edema and ecchymosis. Injection of lidocaine and adrenaline is recommended to reduce bleeding. Whilst the lidocaine and adrenaline combination (LAC) is claimed to reduce postoperative ecchymosis and edema, this effect remains to be proven conclusively. This study, on 48 patients, was designed to investigate the effects of LAC injection on postoperative edema/ecchymosis in rhinoplasty. LAC was applied at a random side prior to the lateral osteotomy. The opposite side was used as a control. The relationship between edema/ecchymosis and the degree of LAC on the injected and uninjected sides was evaluated on the first, third and seventh day postoperatively. The relationships between edema and ecchymosis with operation time and intraoperative systolic blood pressure were also evaluated. Bleeding was reduced on the side treated with LAC ( p = 0.050). The degrees of edema/ecchymosis increased with increases in the duration of operation and the systolic blood pressure on the first postoperative day for the LAC-applied side ( p < 0.05). This correlation was not observed on the opposite side ( p > 0.05). Application of LAC reduces bleeding during rhinoplasty and pain control postoperatively but reduced edema and ecchymosis should not be expected following LAC application.