Department of Ophthalmology and Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ophthalmic Plast Reconstr Surg. 2013 May-Jun;29(3):198-200. doi: 10.1097/IOP.0b013e318281ec82.
To evaluate the effect of local anesthesia with bupivacaine plus epinephrine on the extent of blepharoptosis and levator palpebrae muscle function.
: 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.
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.
: 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.
评估布比卡因加肾上腺素局部麻醉对眼睑下垂程度和提上睑肌功能的影响。
本研究为前瞻性介入病例系列研究，纳入了需要进行腱膜切开术的眼睑下垂患者。在手术室进行初步准备后，在上眼睑共注射 1 毫升 0.5%布比卡因加 1:100,000 肾上腺素混合液。在注射前、注射后 2、5、10 和 15 分钟测量睑裂反射距离 1（MRD1）和提上睑肌功能的程度。
共纳入 36 只眼，其中 21 只眼为男性（58.3%），15 只眼为女性（41.7%），平均年龄为 41.81±23.09 岁（17-83 岁）。其中 21 只眼为肌源性眼睑下垂，15 只眼为腱膜性眼睑下垂。注射前 MRD1 的平均值为 1.18±1.06mm，分别在注射后 2、5、10 和 15 分钟时为-0.02±0.85、0.52±0.98、0.98±1.05 和 1.02±1.06mm。所有时间点的 MRD1 测量值变化均具有统计学意义。88.8%的眼在注射后前 2 分钟内 MRD1 值下降，但在 15 分钟后恢复初始值。注射后 2 分钟和 5 分钟时提上睑肌功能测量值的变化具有统计学意义，但差异在临床上可忽略不计。
1ml 布比卡因加肾上腺素局部麻醉眼睑可在最初几分钟内引起暂时性眼睑下垂增加，对提上睑肌功能测量值的影响极小。
