Nitrous Oxide Improves Tissue Perfusion in Vascular Occlusion Management
Stella Desyatnikova1, Leandra Mangieri1
1From the Stella Center, Seattle, Wash.
Plastic and Reconstructive Surgery. Global Open
|July 27, 2023
Summary
Managing filler-related vascular occlusion (VO) is challenging. Adjunctive nitrous oxide (N2O) with hyaluronidase injections eased patient pain and anxiety, improving skin perfusion in two VO cases.
Area of Science:
- Dermatology
- Aesthetic Medicine
- Pain Management
Background:
- Filler-related vascular occlusion (VO) treatment is complex, often involving hyaluronidase injections and ultrasound guidance.
- Patient pain and anxiety during VO treatment are significant management challenges.
- Nitrous oxide (N2O) is established for analgesia and anxiolysis in other procedures.
Observation:
- Two cases of filler-related VO were treated with high-dose hourly hyaluronidase and self-administered 50% N2O.
- Patients self-reported pain and anxiety levels.
- Skin perfusion was monitored via capillary refill and livedo reticularis to assess VO treatment outcomes.
Findings:
- Self-administered N2O provided immediate improvement in skin perfusion.
- Patients reported significant reductions in pain and anxiety during the procedure.
- Hyaluronidase treatment successfully resolved VO symptoms permanently.
Implications:
- Nitrous oxide (N2O) shows promise as an adjunctive therapy for managing pain and anxiety in filler-related VO.
- N2O may offer additional benefits in improving skin perfusion during VO treatment.
- Further research is needed to establish the role and optimal use of N2O in VO management.
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