Are you using medication for high blood pressure? Almost all blood pressure medication can simply be continued around an eyelid correction. With 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 preparations: Seretide, Symbicort, Relvar
- Oral corticosteroids (for severe asthma or lung attacks): prednisone, prednisolone
Why is this relevant?
Inhaled medication generally has little influence on an eyelid correction under local anaesthetic; this medication works mainly locally in the lungs. Still, it is important that we know that you have asthma or COPD, because stress and tension around a procedure can in rare cases trigger an asthma attack.
With the use of (long-term) oral corticosteroids such as prednisone, a different story applies: this medication can slow down wound healing and increase the risk of infection, and is associated with wound dehiscence (the opening up of a wound) [1,2]. In addition, long-term prednisone use can suppress adrenal function, which is important around a surgical procedure [3].
Points of attention
- Always bring your inhaler to the procedure, in case you need it
- Are you using prednisone or another oral corticosteroid regularly or recently? Always report this; 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 is simply continued around the procedure, and you may bring it to the clinic.
3. Attention to wound healing with prednisone use
With recent or long-term use of oral corticosteroids, we take extra account of wound healing and, if necessary, schedule an extra follow-up check [1,2].
4. Calm environment
We ensure a calm, relaxed setting during the procedure to limit stress-related complaints.
Important: asthma and COPD medication (such as Ventolin, Seretide or Symbicort) is generally not a contraindication for an eyelid correction. Recent or long-term use of prednisone requires extra attention to wound healing.
When do we advise against the procedure (for the time being)?
- In the case of poorly controlled asthma or COPD with recent lung attacks
- In the case of high doses of oral corticosteroids without consultation with the pulmonologist [1,3]
- If the pulmonologist advises against the procedure at this time
Our advice
Are you using medication for asthma or COPD, or have you recently used prednisone? Discuss this during the 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
