Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
Ophthalmic Plast Reconstr Surg. 2010 Jan-Feb;26(1):33-5. doi: 10.1097/IOP.0b013e3181b80c13.
To determine whether there is a difference in the incidence of short-term complications using plain lidocaine with epinephrine versus the buffered equivalent in eyelid surgery.
The authors performed a prospective, double-masked, randomized study in patients scheduled for combined upper eyelid blepharoplasty and levator advancement ptosis repair surgery with local anesthesia. Exclusion criteria included: documented allergies to lidocaine and/or epinephrine; known pregnancy; profound cognitive impairment; inability to understand the visual analog scale or the informed consent; and previous eyelid surgery. Each subject was his/her own control by using the unbuffered local anesthetic in one eye, while the buffered solution was used in the other eye. The surgeon completed a specific standardized data collection form for quantifying both intraoperative and postoperative complications, such as bleeding, bruising, and edema. Data regarding pain on injection and postoperative pain were collected from patients using a visual analog pain scale.
Thirty-nine patients were included in this study, of which 18 experienced less pain during the injection on the side where buffered lidocaine was used, 11 reported no difference, and 10 reported less pain in the eye injected with unbuffered lidocaine. Injection pain revealed a mean operative pain rating of 4.01 +/- 2.45 in the eye with buffered lidocaine versus 4.49 +/- 2.58 in the control (p = 0.06). There were no significant differences between the buffered and unbuffered lidocaine eyes as regards postoperative bleeding, swelling, or pain, and there was a trend toward less pain on injection with the buffered solution.
There were no significant differences in postoperative pain, swelling, or bleeding with the use of plain versus buffered lidocaine in eyelid surgery. There was a trend for the buffered anesthetic to cause less pain on injection.
比较含肾上腺素的普通利多卡因和缓冲利多卡因在眼睑手术中短期并发症发生率的差异。
作者对拟行局部麻醉下联合上睑成形术和提上睑肌前徙术矫正上睑下垂的患者进行了前瞻性、双盲、随机研究。排除标准包括：利多卡因和/或肾上腺素过敏史；已知妊娠；严重认知障碍；无法理解视觉模拟评分或知情同意书；以及先前的眼睑手术。每位患者均为自身对照，一侧眼使用未缓冲的局部麻醉剂，另一侧眼使用缓冲溶液。外科医生使用特定的标准化数据收集表来量化术中及术后并发症，如出血、瘀伤和水肿。使用视觉模拟疼痛量表从患者处收集有关注射时疼痛和术后疼痛的数据。
本研究共纳入 39 例患者，其中 18 例在使用缓冲利多卡因的一侧注射时疼痛较轻，11 例报告无差异，10 例报告在未缓冲利多卡因注射的眼中疼痛较轻。注射疼痛显示使用缓冲利多卡因的眼中平均手术疼痛评分为 4.01 +/- 2.45，而对照眼中为 4.49 +/- 2.58（p = 0.06）。在术后出血、肿胀或疼痛方面，缓冲和未缓冲利多卡因眼之间没有显著差异，并且缓冲溶液注射时疼痛趋势较轻。
在眼睑手术中使用普通利多卡因和缓冲利多卡因在术后疼痛、肿胀或出血方面没有显著差异。缓冲麻醉剂注射时疼痛较轻的趋势。
