Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
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Finding the optimal time delay for skin incision in oculoplastic surgery after injection of lidocaine with epinephrine
Author: Ulf Dahlstrand
ePoster Number: 252
Epinephrine is routinely used in local anesthetics to reduce bleeding and prolong the anesthetic effect. It induces vasoconstriction locally, but the optimal delay between the administration of the local anesthetic and skin incision has not been fully determined. This is the first study to assess blood perfusion in response to a local anesthetic containing epinephrine in oculoplastic surgery.
A local anesthetic consisting of lidocaine and epinephrine (20 mg/ml + 12.5 μg/ml, 1:80000) was injected into the eyelids of 9 subjects undergoing blepharoplasty. The perfusion was monitored using laser speckle contrast imaging (LSCI) and oxygenation (sO2) was monitored using hyperspectral imaging (HSI).
LSCI monitoring showed a decrease in perfusion over time at the site of injection. Half-maximum effect was reached after 34 s, and full effect after 115 s, determined by exponential fitting. Perfusion decreased gradually further away from the injection site and hypoperfusion was less prominent here. Four mm from the injection site, the time to half-maximum effect was 231 s. HSI showed only a slight decrease in sO2 of 10 -15 % in the center.
The optimal time delay for skin incision in oculoplastic surgery is around 2 minutes after the injection of lidocaine with epinephrine (1:80000). Waiting longer does not lead to a further decrease in perfusion. As oxygenation was only slightly reduced after injection with epinephrine, the results indicate that the use of epinephrine is safe in the periocular region.
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Abstract ID: 21-149