Ensat Florian, Heinrich Klemens, Kholosy Hassan Mahmoud, Wimbauer Julia, Hladik Michaela, Wechselberger Gottfried
Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
J Plast Reconstr Aesthet Surg. 2017 Mar;70(3):375-379. doi: 10.1016/j.bjps.2016.10.014. Epub 2016 Nov 19.
Upper blepharoplasties are a common procedure in plastic surgery. This procedure can be performed effectively under local anesthesia with or without sedation. The ideal local anesthetic should cause less intraoperative bleeding and less postoperative edema. Our study aimed to show the difference between the two local anesthetics 1% prilocaine (Xylonaest) in combination with epinephrine 1:100,000 and ropivacaine (Naropin) in combination with epinephrine 1:100,000 including sodium chloride, particularly in regard to swelling and bleeding in patients undergoing upper blepharoplasties.
In this double-blind, prospective, randomized study, 31 patients between March 2014 and September 2014 were included. The anesthetic agents used in all cases were 1% prilocaine (Xylonaest) in combination with epinephrine 1:100,000 for one side and ropivacaine consisting of 10-mg Naropin, 5-ml sodium chloride, and 1-ml epinephrine for the other side. The data presented in this study were collected by one of the surgeons performing the surgery. Intraoperative bleeding and postoperative edema were both calculated using a score of five points for each.
The average bleeding tendency was 3.39 for prilocaine and 1.71 for local ropivacaine, showing a significant difference (p < 0.0001) between both local anesthetics in bleeding tendency. There was also a significant minor swelling at all times on the side on which ropivacaine was used.
In our study, we demonstrated that ropivacaine (Naropin) has less intra- and postoperative side effects including swelling and bleeding compared with prilocaine (Xylonaest).
上睑成形术是整形外科的常见手术。该手术在局部麻醉下,无论有无镇静均可有效进行。理想的局部麻醉剂应使术中出血更少且术后水肿更轻。我们的研究旨在显示两种局部麻醉剂的差异,即1%丙胺卡因(赛罗卡因)与1:100,000肾上腺素联合使用,以及罗哌卡因(耐乐品)与1:100,000肾上腺素联合使用(含氯化钠),特别是在上睑成形术患者的肿胀和出血方面。
在这项双盲、前瞻性、随机研究中,纳入了2014年3月至2014年9月期间的31例患者。所有病例中,一侧使用1%丙胺卡因(赛罗卡因)与1:100,000肾上腺素联合,另一侧使用由10毫克耐乐品、5毫升氯化钠和1毫升肾上腺素组成的罗哌卡因。本研究中的数据由其中一位实施手术的外科医生收集。术中出血和术后水肿均采用五分制评分。
丙胺卡因的平均出血倾向为3.39,局部罗哌卡因的平均出血倾向为1.71,两种局部麻醉剂在出血倾向方面存在显著差异(p < 0.0001)。使用罗哌卡因的一侧在所有时间也都有明显较小的肿胀。
在我们的研究中,我们证明与丙胺卡因(赛罗卡因)相比,罗哌卡因(耐乐品)的术中和术后副作用(包括肿胀和出血)更少。