Effects of local anesthesia with bupivacaine plus epinephrine on blepharoptosis and levator palpebrae muscle function.

Abstract

PURPOSE:

To evaluate the effect of local anesthesia with bupivacaine plus epinephrine on the extent of blepharoptosis and levator palpebrae muscle function.

METHODS:

: In this prospective interventional case series, patients with blepharoptosis who were candidates for aponeurotic surgery were included. After initial preparations in the operating room, a total of 1 ml of a mixture of bupivacaine 0.5% plus epinephrine 1:100,000 were injected into the upper eyelid. The margin reflex distance 1 (MRD1) and the extent of levator muscle function were measured before and 2, 5, 10, and 15 minutes after injection.

RESULTS:

A total of 36 eyes including 21 men (58.3%) and 15 women (41.7%) with an average age of 41.81 ± 23.09 (17-83 years) were studied. There were 21 eyes with myogenic and 15 eyes with aponeurotic blepharoptosis. The mean MRD1 was 1.18 ± 1.06 mm before injection and -0.02 ± 0.85, 0.52 ± 0.98, 0.98 ± 1.05, and 1.02 ± 1.06 mm at 2, 5, 10, and 15 minutes after injections, respectively. The changes in the MRD1 measurements were statistically significant at all time points. The MRD1 values decreased during the first 2 minutes after injection in 88.8% of eyes, but returned to initial value after 15 minutes in 84.3%. The change in the levator muscle function measurements was statistically significant at 2 and 5 minutes after injections; however, the differences were clinically negligible.

CONCLUSIONS:

: The local anesthesia of the eyelid with 1 ml bupivacaine plus epinephrine causes a temporary increase of blepharoptosis within the first few minutes with minimal effect on levator muscle function measurements.

• Authors: Gholam Hoseyn Aghai, Maryam Vazirnia, Rama Poormatin, Khalil Ghasemi Falavarjani
• Journal: Ophthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) 2013 May-Jun Vol. 29 Issue 3 Pg. 198-200 ISSN: 1537-2677 [Electronic] United States
• PMID: 23446306 (Publication Type: Journal Article)

Chemical References

• Anesthetics, Local
• Drug Combinations
• Sympathomimetics
• Bupivacaine
• Epinephrine

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anesthesia, Local (methods)
• Anesthetics, Local (administration & dosage)
• Blepharoptosis (diagnosis, physiopathology, surgery)
• Blinking (physiology)
• Bupivacaine (administration & dosage)
• Drug Combinations
• Epinephrine (administration & dosage)
• Eyelids (drug effects)
• Female
• Humans
• Injections, Intraocular
• Male
• Middle Aged
• Oculomotor Muscles (physiopathology, surgery)
• Prospective Studies
• Sympathomimetics (administration & dosage)
• Young Adult