Chapped lips are the most common congenital deformity in the oral and maxillofacial region, with an incidence rate of approximately one in a thousand. Therefore, chapped lips repair surgery is a typical procedure commonly performed in oral and maxillofacial surgery. To restore the normal anatomical form and function of the upper lip and the area below the nose, in addition to requiring the surgeon to be proficient in the design and precise methods of the surgery, it also demands that the surgical operation be steady, accurate, and gentle to ensure a good cosmetic outcome. Chapped lips repair surgery can be completed under local anesthesia and acupuncture anesthesia. Pediatric patients generally should choose basal anesthesia combined with local anesthesia. Among adult patients, those who urgently require the surgery are mostly willing to actively cooperate, providing favorable conditions for performing chapped lips repair surgery under acupuncture anesthesia, and the effects of acupuncture anesthesia are also quite satisfactory. In 1978, the Anesthesia Group of the Oral and Maxillofacial Surgery Department at Sichuan Medical College conducted a statistical analysis of the effects of acupuncture anesthesia in 63 cases of chapped lips repair surgery, with a grade I and II effectiveness rate of 75.5%.

Case Selection

Any adult willing to undergo surgery under acupuncture anesthesia can be considered. However, patients who are difficult to cooperate are not suitable for this anesthesia method.

Methods to Improve Acupuncture Anesthesia Effectiveness

Chapped lips repair surgery is a highly demanding cosmetic procedure. The surgical field should not be injected with any liquid medication to avoid facial tissue swelling that could affect the cosmetic outcome. To strive for improved acupuncture anesthesia effectiveness, the following points should be noted during the anesthesia process:

In chapped lips repair, full-thickness incision of the red and white lips is an operation step that easily causes pain. Before incising the upper lip, the surgeon should apply appropriate pressure with the thumb and index finger near the corner of the mouth, which not only reduces bleeding but also alleviates pain during the skin incision.

During chapped lips repair surgery, due to different degrees of needling sensation on both sides, one side may have good acupuncture anesthesia effect while the other side is poorer. At this time, the electrical stimulation parameters can be adjusted for the side with poor needling sensation, increasing the stimulation intensity. The combination of electrodes requires pairing of acupoints on the same side.

For unilateral grade III chapped lips and bilateral grade III chapped lips, when closing the nasal base and lifting the medial nasal mucoperiosteal flap, 0.5 to 1 ml of 1/500,000 adrenaline solution can be injected, which not only reduces bleeding but also enhances the analgesic effect of acupuncture anesthesia.

Suturing during chapped lips surgery is a major operation step. Using a general method of fast needle insertion and fast needle withdrawal often causes pain. Under anesthesia, a method of slow needle insertion and gentle thread pulling should be used to reduce the pain response.