A Prospective Self-Control Study Of Lidocaine-Epinephrine Versus Lidocaine-Ropivacaine-Epinephrine In Full Incision Eyelid Plasty

Objective: To investigate the anesthesia potency,intraoperative bleeding,swelling effect between 1% lidocaine-epinephrine and 1% lidocaine-0.375% ropivacaineepinephrine in full-incision double eyelid plasty.Methods: Through a prospective approach,a total of 40 patients who underwent the double eyelid plasty and met the inclusion criteria were selected to participate in this study from January 2019 to July 2019.Different ratio of anesthetic(1%lidocaine-epinephrine 1:20 0000 on one side,1% lidocaine 0.375% ropivacaineepinephrine 1:1:20 0000 on the other side eyelid)was injected randomly.Then the surgery operation begin,observing the pain score(Wong-Baker facial visual pain scale)immediately after surgery,and the evaluation were repeated in postoperative 2 h,6 h,10 h,1 d and 2 d.The intraoperative bleeding score,postoperative swelling rate of 1 d were rated as well.WILCOXON rank sum test was used to analyze the data.Results: 38 female and 2 male were selected in this study(80 eyelids).The average age was 24±2.92 years,and all of the patients completed the surgery under local anesthesia.Eyelids with lidocaine-epinephrine anesthesia were set for L group,and the other side which received lidocaine-ropivacaine-epinephrine were set for R group.In the immediate period after surgery,the pain score of L group is: 2.05±0.78,and that for R group is: 2.10±0.74.The pain score of L group was less than R group and there was no statistically significant difference(p > 0.05).2h after the operation,the pain score of the L group was 4.73±1.06,and the R group was 4.2±0.91.The pain score of the L group was higher than that of the R group with statistically significant difference(p<0.05).6h after surgery,the pain score of the L group was 4.75±0.84,the R group was 3.88±0.76.The pain score of the L group was higher than that of the R group with statistically significant difference(p<0.05).10 h after surgery,the pain score of the L group was3.7±0.75,and that of the R group was 3.175±0.67.The pain score of the L group was higher than that of the R group,and the difference was statistically significant(p<0.05).1d after surgery,the pain score of the L group was 2.78±0.80,and that of the R group was 2.3±0.60.The pain score of the L group was higher than the R group with statistically significant difference(p<0.05).2d after surgery,the pain score of the L group was 1.48±0.51,and that of the R group was 1.33±0.47.The pain score of the L group was higher than that of the R group,with no significant difference(p>0.05).In terms of intraoperative bleeding,the L group was 2.70±0.72,and the R group was2.38±0.74,showing no statistically significant difference(p>0.05).In terms of swelling score in one day after surgery,the L group was 3.55±0.59,and the R group was3.58±0.63,showing no statistically significant difference(p>0.05).No complications such as hematoma,skin necrosis and infection were observed in both sides after operation.Conclusion: The 1% lidocaine-0.375% ropivacaine-1:1:20 0000 epinephrine anesthesia can prolong the postoperative analgesia effect in double eyelid plasty and the intraoperative bleeding score,postoperative swelling risks were not increasing.This study provides a basis for choosing a modified local anesthetic in the body surface surgery.The uncomfortable feeling can be relieved by this solution and the satisfaction degree of patients increase at the same time.This method can be further applied in clinical procedures.