Mindre smerte ved lokalbedøvelse

Finsen, Vilhjalmur

doi:10.4045/tidsskr.16.0515

Cited by 11 publications

(2 citation statements)

References 22 publications

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“…For individuals undergoing minor surgery, the administration of local anesthesia is often the most painful aspect of the procedure. The pain results from the skin being pierced, the injected fluid stimulating stretch receptors in the underlying tissues, and the chemical composition of the substance [17]. Our study yielded similar results, with most patients identifying anesthetic administration as the most painful and stressful part of blepharoplasty.…”

Section: Discussionsupporting

confidence: 66%

Optimizing Perioperative Experience in Upper Blepharoplasty: The Impact of Premedication on Anxiety, Pain, and Patient Satisfaction

Suslavičius,

Liutkauskaitė,

Zacharevskij

et al. 2024

Cureus

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BackgroundThe periorbital area undergoes transformative changes with age, influencing both aesthetic appearance and functional aspects of the eyelids. Age-related alterations involve volume loss, shifts in eyelid crease position, drooping eyebrows, reduced skin elasticity, and the presence of dermatochalasis. Dermatochalasis, characterized by redundant upper eyelid skin folds, poses aesthetic and functional challenges, impacting visual acuity and eyelid elevation efficiency. Upper blepharoplasty addresses these age-related changes. Despite the elective nature of upper blepharoplasty, the procedure can evoke preoperative anxiety and discomfort. Various premedication strategies, including benzodiazepines, aim to alleviate anxiety and enhance the overall patient experience. However, ongoing debates persist regarding the optimal strategy for implementation. The study aims to contribute insights into the effectiveness of different premedication approaches in optimizing patient comfort during and after upper blepharoplasty. MethodsThe research design involves 182 patients divided into three groups: control group (CG) (n = 45) receiving no premedication, Group 1 (n = 98) receiving oral midazolam (a benzodiazepine), and Group 2 (n = 39) receiving a combination of midazolam, eutectic mixture of local anesthetics (EMLA) eyelid ointment, and oral paracetamol with codeine phosphate hemihydrate. The study assesses anxiety levels, pain perception during local anesthetic injection, surgery, and postoperatively, as well as the use of painkillers and adverse effects. Ethical approval was obtained for the study. ResultsSignificant differences were noted among the groups during local anesthetic injection (p < 0.0001), surgery (p < 0.0001), and post surgery (p < 0.0197). CG patients experienced higher pain levels during local anesthetic injection and surgery compared to Groups 1 and 2. Group 1 reported more pain during surgery than Group 2. Substantial differences were observed in preoperative (p < 0.0001), during-surgery (p < 0.0001), and after-surgery (p < 0.0001) anxiety levels. The CG exhibited higher preoperative anxiety compared to Group 1, while Group 1 had lower anxiety during surgery compared to the CG. Group 1 also reported lower anxiety after surgery than both the CG and Group 2. A significant difference was found in post-surgery painkiller usage among the groups (p = 0.0003). Group 2 showed significantly lower usage compared to Group 1 (p = 0.0004) and the CG (p = 0.0006). A significant difference was observed in the duration of painkiller use after surgery (p < 0.0014). The CG had a longer duration than Group 1 (p = 0.0049) and Group 2 (p = 0.0495). ConclusionsMidazolam alone as premedication effectively reduced anxiety before, during, and after surgery. EMLA administration for injection pain did not produce superior results, likely due to its delayed onset. Paracetamol with codeine phosphate hemihydrate effectively reduced surgical pain and postoperative pain duration and decreased the need for painkillers.

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Section: Discussionsupporting

confidence: 66%

Optimizing Perioperative Experience in Upper Blepharoplasty: The Impact of Premedication on Anxiety, Pain, and Patient Satisfaction

Suslavičius,

Liutkauskaitė,

Zacharevskij

et al. 2024

Cureus

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“…However, providers should be aware of the varied responses to pain with differing angles of injection 26 . In addition, buffering the lidocaine with sodium bicarbonate, warming it to body temperature, and using a smaller diameter needle are methods shown to reduce the pain, and potentially anxiety, upon injection 27,28 . For centuries, the use of hypnosis has been well‐known to relieve pain during surgical procedures.…”

Section: Intraoperative Interventionsmentioning

confidence: 99%

A practical guide to reducing preoperative and intraoperative patient anxiety in dermatologic surgery

Yousif,

Alkhouri,

St. Claire

et al. 2023

Int J Dermatology

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BackgroundDermatologists perform a variety of procedures including excisions, biopsies, and other minor surgical procedures. Patients can experience anxiety in anticipation of their surgeries or may develop anxiety during the procedure. Since most dermatologic procedures occur with the patient awake and alert, the physician can offer comforting methods to alleviate some of that anxiety.AimsWe wanted to provide a review of available methods that dermatologists can use to reduce patient anxiety.Materials & MethodsIn this paper, we review the current literature on methods that can be used in dermatology offices to reduce overall patient anxiety levels.ResultsIn the preoperative stage, providers can offer educational content to explain the procedure to their patients. Whether it be through telephone calls, educational videos, or utilization of visual models, educating the patient regarding their procedure may reduce their anxiety. Intraoperatively, there are multiple methods that can be used such as music, guided imagery, coloring books, medications, hypnosis, and distraction techniques.Discussion & ConclusionThere is a variety of approaches that can be easily implemented in the office and can help in reducing the anxiety of the patients to allow for a pleasant patient experience and an overall satisfactory procedure outcome.

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Patient Comfort with Various Local Infiltration Anesthetics for Minor Oculoplastic Surgery: A Systematic Review and Network Meta-Analysis

Liu¹,

Wu²,

Liou³

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Mindre smerte ved lokalbedøvelse

Cited by 11 publications

References 22 publications

Optimizing Perioperative Experience in Upper Blepharoplasty: The Impact of Premedication on Anxiety, Pain, and Patient Satisfaction

Optimizing Perioperative Experience in Upper Blepharoplasty: The Impact of Premedication on Anxiety, Pain, and Patient Satisfaction

A practical guide to reducing preoperative and intraoperative patient anxiety in dermatologic surgery

Patient Comfort with Various Local Infiltration Anesthetics for Minor Oculoplastic Surgery: A Systematic Review and Network Meta-Analysis

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