title: [Ocular side effects of added sympathomimetics in local anesthetics].
abstract: In facial dermatosurgery, the addition of sympathomimetics to local anesthetics produces a desirable topical effect as they provide an almost bloodless operation field due to temporary vasoconstriction. In an 87-year-old woman, who had lost her left sight owing to a meningoma, we removed a basal-cell carcinoma from the right side of her nose. The local anesthetic applied contained noradrenaline at a concentration of 1:50,000. After the operation, the patient complained of a headache and a transitory loss of sight. We suppose that noradrenaline reached the arteria centralis retinae via arterial periorbital anastomoses, thus causing a vasoconstriction of this artery. As far as dermatosurgery of the middle and upper face is concerned, patients with severe vision disorders should be considered as a risk group; in local anesthesia of those patients an addition of sympathomimetics should be avoided.
authors.forename: M
authors.initials: M
authors.lastname: Häberle
authors.forename: H
authors.initials: H
authors.lastname: Fischer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D002280:Basal Cell Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D009638:Norepinephrine / Q000009:adverse effects*; D009669:Nose Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012161:Retinal Artery / Q000187:drug effects*; D014661:Vasoconstriction / Q000187:drug effects; D014792:Visual Acuity / Q000187:drug effects; D014794:Visual Fields / Q000187:drug effects
chemical_list: D009638:Norepinephrine
vernacular_title: Nebenwirkungen am Auge von Sympathomimetikazusätzen in Lokalanästhetika.