Department of Otolaryngology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
Int J Oral Maxillofac Surg. 2011 Jul;40(7):722-9. doi: 10.1016/j.ijom.2011.02.022. Epub 2011 Apr 1.
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.
鼻骨切开术是引起眶周水肿和瘀斑的最主要原因。推荐使用利多卡因和肾上腺素注射来减少出血。虽然利多卡因和肾上腺素联合使用（LAC）据称可减少术后瘀斑和水肿，但这一效果仍有待确凿证明。本研究纳入了 48 例患者，旨在探讨 LAC 注射对鼻整形术后水肿/瘀斑的影响。在外侧骨切开术之前，LAC 随机应用于一侧。另一侧作为对照。术后第 1、3、7 天评估注射侧和未注射侧的水肿/瘀斑与 LAC 程度之间的关系。还评估了水肿与瘀斑与手术时间和术中收缩压之间的关系。LAC 治疗侧的出血减少（p=0.050）。对于 LAC 应用侧，术后第 1 天，手术时间和收缩压的增加与水肿/瘀斑程度的增加相关（p<0.05）。但在对侧未观察到这种相关性（p>0.05）。在鼻整形术中应用 LAC 可减少出血和术后疼痛控制，但不应期望 LAC 应用后会减少水肿和瘀斑。
