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Guide to Local Anesthetic Medications

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Pearls and Pitfalls in Cosmetic Oculoplastic Surgery

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Abstract

Proparacaine or tetracaine drops can be applied to the ocular surface to help minimize the discomfort of subconjunctival injections. Facial prep solutions, bright lights, and repeated opening of eyes intraoperatively to adjust lid height may cause drying and ocular irritation. Treating both eyes helps increase patient comfort and cooperation. Tetracaine is the most potent topical agent1 and can be used directly on the tarsal plate during procedures such as ptosis repair in which anesthetic use is minimized to avoid levator muscle paralysis. Use of topical anesthetic drops should be limited in all patients to prevent iatrogenic corneal epitheliopathy. The postoperative analgesic regimen should never include topical ocular anesthetic agents.

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References

  1. Benz JD. Injectable local anesthetics. AORN J 1992;55:274–284.

    Article  CAS  PubMed  Google Scholar 

  2. Tetzlaff JE. The pharmacology of local anesthetics. Anesthesiol Clin North Am 2000;18:217–233.

    Article  CAS  Google Scholar 

  3. Krunic AL, Wang LC, Soltani K, Weitzul S, Taylor RS. Digital anesthesia with epinephrine: an old myth revisited. J Am Acad Dermatol 2004;51:755–759.

    Article  PubMed  Google Scholar 

  4. Brown RS, Rhodus NL. Epinephrine and local anesthesia revisited. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100(4):401–408.

    Article  CAS  PubMed  Google Scholar 

  5. New York Heart Association. Use of epinephrine in connection with procaine in dental procedures. J Am Dent Assoc 1955;50:108.

    Google Scholar 

  6. Lidocaine and prilocaine. Available at: http://www.rxlist.com/cgi/generic2/emla.htm. Accessed November 19, 2005.

    Google Scholar 

  7. Davies RJ. Buffering the pain of local anaesthetics: a systematic review. Emerg Med 2003;15:81–88.

    Article  Google Scholar 

  8. Parham SM, Pasieka JL. Effect of pH modification by bicarbonate on pain after subcutaneous lidocaine injection. Can J Surg 1996;39:31–35.

    CAS  PubMed  Google Scholar 

  9. Yuen VH, Dolman PJ. Comparison of three modified lidocaine solutions for use in eyelid anesthesia. Ophth Plast Reconstr Surg 1999;15:143–147.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Oculoplastics and Orbital Consultants, Charlottesville, VA, USA

    Vivian Schiedler MD

  2. Allure Laser Center and Medispa, Kirkland, WA, USA

    Bryan S. Sires MD, PhD

Authors
  1. Vivian Schiedler MD
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  2. Bryan S. Sires MD, PhD
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Editor information

Editors and Affiliations

  1. Department of Ophthalmology and Division of Plastic and Reconstructive Surgery, Saint Louis University, St. Louis, MO, USA

    Morris E. Hartstein MD, FACS (Clinical Associate Professor) (Clinical Associate Professor)

  2. Departments of Ophthalmology and Otolaryngology-Head and Neck Surgery, Saint Louis University, St. Louis, MO, USA

    John B. Holds MD, FACS (Clinical Professor) (Clinical Professor)

  3. Ophthalmic Plastic and Reconstructive Surgery, American Eye Institute, Cedars Sinai Medical Center, Los Angeles, CA

    Guy G. Massry MD (Director) (Director)

  4. Spalding Dr. Cosmetic Surgery and Dermatology, Beverly Hills, CA

    Guy G. Massry MD (Director) (Director)

  5. Davidorf Eye Group, West Hills, CA, USA

    Guy G. Massry MD (Director) (Director)

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© 2008 Springer Science+Business Media, LLC

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Schiedler, V., Sires, B.S. (2008). Guide to Local Anesthetic Medications. In: Hartstein, M.E., Holds, J.B., Massry, G.G. (eds) Pearls and Pitfalls in Cosmetic Oculoplastic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69007-0_4

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  • DOI: https://doi.org/10.1007/978-0-387-69007-0_4

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-25389-3

  • Online ISBN: 978-0-387-69007-0

  • eBook Packages: MedicineMedicine (R0)

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