Evaluating pain in different local anesthesia formulas for upper eyelid surgery
Author: Shay Keren
Base Hospital / Institution: Hillel-Yaffe
ePoster presentation
Abstract ID: 25-307
Purpose
To evaluate the difference in pain during anesthesia injection and throughout surgery between the common anesthesia and a combination with bicarbonate 8.4%.
Methods
All patients undergoing upper lid blepharoplasty in the Hille-Yaffe medical center were enrolled to the trial after consenting. One eyelid was injected with a combination of 2 ml lidocaine 2% with 2 ml bupivacaine 0.5% with 1:200,000 adrenaline (normal) and the other eyelid with the exact same combination with the addition of 0.5 ml sodium bicarbonate 8.4% (enhanced). The sides of the different solutions were decided in a random way.
Every patient gave a score of 0-10 to the level of pain in each eye in 2 points: right after the anesthesia injection and in the end of the surgery.
Results
14 patients, 14 females, age 46-79 (mean 64.7) were enrolled. The right eye was always the first one injected. The normal combination was the first one injected in 7 cases.
The mean pain level with the normal combination were 6.93 and the enhanced 2.71 (p=0.001). It was shown that the order of injection did change the score. If the eye with the enhanced anaesthesia was injected first it was less painful (p=0.02). The mean pain throughout surgery was 1.11 vs 0.43 (p=0.11).
Conclusion
The addition of bicarbonate and basically buffering the local anesthesia solution has a very positive effect on patient satisfaction and reduces pain in the only part of surgery where pain is felt. Injecting it after the painful injection masks part of the effect.
It is safe and easy to use and should be incorporated in local anestheia in the periocular area.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Polina | Isakovich albagly | Hillel-Yaffe |
| Yara | Karawani | Hillel-Yaffe |
| Alona | Yaakobi | Hillel-Yaffe |
| Beatrice | Tiosano | Hillel-Yaffe |
