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A Prospective, Comparative Study of the Pain of Local Anesthesia Using 2% Lidocaine, 2% Lidocaine With Epinephrine, and 2% Lidocaine With Epinephrine-Bupivicaine Mixture for Eyelid Surgery.

 Jung-woo Han  ;  Seung Kwan Nah  ;  Sang Yeul Lee  ;  Chang Yeom Kim  ;  Jin Sook Yoon  ;  Sun Young Jang 
 Urologic Oncology - Seminars and Original Investigations, Vol.33(2) : 132-135, 2017 
Journal Title
 Urologic Oncology - Seminars and Original Investigations 
Issue Date
Adolescent ; Adult ; Aged ; Anesthesia, Local/methods* ; Anesthetics, Local/therapeutic use* ; Bupivacaine/therapeutic use* ; Double-Blind Method ; Drug Therapy, Combination ; Epinephrine/therapeutic use* ; Eyelids/surgery* ; Female ; Humans ; Lidocaine/therapeutic use* ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures* ; Pain Measurement ; Young Adult
PURPOSE: A mixture of 2% lidocaine with epinephrine and bupivacaine was developed to achieve the fast-onset anesthetic effect of lidocaine and the long-lasting effect of bupivacaine. The authors compared pain scores between 2% lidocaine, 2% lidocaine with epinephrine, and 2% lidocaine with epinephrine-bupivicaine mixture during local anesthesia for eyelid surgeries. METHODS: This was a double-blind, randomized, prospective, comparative study. In total, 120 consecutive patients (43 males, 77 females, mean age = 47.2 ± 21.2) who underwent bilateral eyelid surgery under subcutaneous anesthesia were asked to report pain scores for each eye during the first injection of anesthesia. Each patient was randomly assigned to receive 1 of the 3 anesthetic agents in 1 eyelid, and 1 of the remaining 2 agents in the other. RESULTS: The pH values of the 2% lidocaine, 2% lidocaine with epinephrine, and 2% lidocaine with epinephrine-bupivicaine mixture were 6.23 ± 0.21, 4.21 ± 0.37, and 3.87 ± 0.19, respectively. The pain scores of each were 4.3 ± 1.8, 5.1 ± 1.8, and 5.7 ± 1.9, respectively. The 2% lidocaine with epinephrine produced a statistically significantly higher pain score than 2% lidocaine (p = 0.044, generalized estimating equation method). The mixture also showed a significantly higher pain score than 2% lidocaine (p = 0.003, generalized estimating equation method). CONCLUSIONS: Epinephrine seemed to increase subjective pain scores. Compared with 2% lidocaine with epinephrine, 2% lidocaine with epinephrine-bupivicaine mixture was not significantly different in terms of subjective symptoms or pH.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Yeom(김창염)
Yoon, Jin Sook(윤진숙) ORCID logo https://orcid.org/0000-0002-8751-9467
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