Do you take medication for high blood pressure? Almost all blood pressure medication can simply be continued around an eyelid surgery. For one specific group, the so-called 'non-selective beta blockers', some extra attention is needed because of the local anaesthetic we use.
Which medication does this concern?
- Bronchodilators (short-acting) salbutamol (Ventolin, Airomir)
- Bronchodilators (long-acting) salmeterol, formoterol
- Inhaled corticosteroids budesonide (Pulmicort), fluticasone (Flixotide)
- Combination products Seretide, Symbicort, Relvar
- Oral corticosteroids (for severe asthma or flare-ups) prednisone, prednisolone
Why is this relevant?
Inhaled medication generally has little effect on eyelid surgery under local anaesthetic, as this medication mainly works locally in the lungs. Even so, it is important that we know you have asthma or COPD, because stress and tension around a procedure can in rare cases trigger an asthma attack.
With (long-term) use of oral corticosteroids such as prednisone, it is a different story: this medication can slow wound healing and increase the risk of infection, and is associated with wound dehiscence (a wound opening up) [1,2]. In addition, long-term prednisone use can suppress adrenal function, which matters around a surgical procedure [3].
Discuss it in a personal consultation with plastic surgeon David Jairath, at our clinic for eyelid surgery in Haarlem. A first consultation can usually take place within a week.
Points of attention
- Always bring your inhaler to the procedure, in case you need it
- Do you use prednisone or another oral corticosteroid regularly or recently? Always let us know, as this can affect wound healing [1,2]
- With poorly controlled asthma, stress around the procedure can trigger an attack
Our protocol at Kliniek het Bolwerk
1. Extensive medical history
We ask about your inhaled medication, how often you use it and whether you have used oral corticosteroids in the past few months.
2. Continuing medication
Inhaled medication can simply be continued around the procedure, and you can bring it with you to the clinic.
3. Attention to wound healing with prednisone use
With recent or long-term use of oral corticosteroids, we take extra care with wound healing and, if needed, schedule an extra follow-up appointment [1,2].
4. Calm environment
We provide a calm, relaxed setting during the procedure to limit stress-related symptoms.
Important: asthma and COPD medication (such as Ventolin, Seretide or Symbicort) is generally not a contraindication for eyelid surgery. Recent or long-term use of prednisone calls for extra attention to wound healing.
When do we advise against the procedure (for the time being)?
- With poorly controlled asthma or COPD with recent flare-ups
- With high doses of oral corticosteroids without consulting the lung specialist [1,3]
- If the lung specialist advises against the procedure at this time
Our advice
Do you take medication for asthma or COPD, or have you recently used prednisone? Discuss this during your intake consultation at Kliniek het Bolwerk and bring your inhaler on the day of the procedure.
Literature references
The publications below form the medical-scientific basis of this article:
- Wound dehiscence. Wikipedia (medical overview) https://en.wikipedia.org/wiki/Wound_dehiscence
- Corticosteroid: effects on wound healing and immune response. Wikipedia (medical overview). https://en.wikipedia.org/wiki/Corticosteroid
- Perioperative “stress dose” of corticosteroid: Pharmacological and clinical perspective. Journal of Anaesthesiology Clinical Pharmacology (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598572
