More Comfortable Enjoyment for Upper Eyelid Blepharoplasty: Optimization of Anesthesia Methods Using Stepwise Local Anesthesia Technique.

[BACKGROUND] Perceived pain during local anesthesia injections in double-eyelid blepharoplasty can be influenced by both the epinephrine concentration and local anesthetics components. This study aimed to explore a new stepwise local anesthesia method for upper eyelid blepharoplasty, utilizing ropivacaine mixed with lidocaine, stepwise increase in epinephrine concentration infiltration, and stepwise specific anesthesia application during two surgical procedures.

[METHODS] A prospective randomized clinical trial was conducted on a cohort of patients undergoing upper double-eyelid blepharoplasty, who were randomly divided into two distinct groups: conventional local anesthesia and stepwise anesthetic method. The operative perception pain (VAS), reflexive lacrimation, postoperative periorbital appearance, and patient satisfaction were compared between the two groups.

[RESULTS] A total of 184 patients were included and randomized. The mean visual analog scale (VAS) of the stepwise local anesthesia group was significantly lower than control (T0-T5, all P < 0.001). Meanwhile as for the probability of reflexive lacrimation, stepwise local anesthesia group was lower than control method (P < 0.01). With regard to the periorbital appearance, there are significant differences between two groups in Day 7 at ecchymosis, erythema, and swelling (P < 0.05), and the stepwise local anesthesia method group was lower than control group. However, in 1 month there are no significant differences between two groups. The satisfaction of stepwise local anesthesia group was higher than control (P = 0.016).

[CONCLUSION] In summary, the stepwise local anesthesia technique employed in upper eyelid blepharoplasty demonstrates superior efficacy compared to conventional anesthesia. This technique effectively mitigates pain and immediate postoperative appearance, thereby resulting in heightened patient contentment and justifying its continued endorsement.

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