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, Jinsook Yoon, Sun Young Jang

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)132-135
Number of pages4
JournalOphthalmic Plastic and Reconstructive Surgery
Volume33
Issue number2
DOIs
Publication statusPublished - 2017 Jan 1

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Eyelids
Local Anesthesia
Lidocaine
Epinephrine
Prospective Studies
Pain
Bupivacaine
Anesthetics
Anesthesia

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology

Cite this

@article{e16cf9b0d0cb4563955877bd06a0d489,
title = "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",
abstract = "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.",
author = "Han, {Jung Woo} and Nah, {Seung Kwan} and Lee, {Sang Yeul} and Kim, {Chang Yeom} and Jinsook Yoon and Jang, {Sun Young}",
year = "2017",
month = "1",
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doi = "10.1097/IOP.0000000000000675",
language = "English",
volume = "33",
pages = "132--135",
journal = "Ophthalmic Plastic and Reconstructive Surgery",
issn = "0740-9303",
publisher = "Lippincott Williams and Wilkins",
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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. / Han, Jung Woo; Nah, Seung Kwan; Lee, Sang Yeul; Kim, Chang Yeom; Yoon, Jinsook; Jang, Sun Young.

In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 33, No. 2, 01.01.2017, p. 132-135.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 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

AU - Han, Jung Woo

AU - Nah, Seung Kwan

AU - Lee, Sang Yeul

AU - Kim, Chang Yeom

AU - Yoon, Jinsook

AU - Jang, Sun Young

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

AB - 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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