[Transient vision loss caused by scandicaine with added arterenol in the excision of basalioma of the side of the nose].
In facial dermatosurgery, the addition of sympathomimetics to local anaesthetics produces a desirable topical effect by creating an almost bloodless operation field due to transitory vasoconstriction. In an 87-year-old woman suffering from a meningioma that had caused blindness of the left eye, a basal-cell carcinoma was removed from the right side of the nose. The local anaesthetic contained noradrenaline at a concentration of 1:50,000. After the operation, the patient complained of headache and a transient loss of vision. We suggest that noradrenaline caused vasoconstriction of the arteria centralis retinae via arterial periorbital anastomoses. Patients with severe vision disorders should be considered a risk group, in whom sympathomimetics should not be added to local anaesthetics used in skin surgery of the middle and upper face.
Fischer
H
H
Dermatologische Universitätsklinik Erlangen.
Häberle
M
M
Hornstein
O P
OP
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000009:adverse effects*; D001766:Blindness / Q000139:chemically induced*; D002280:Basal Cell Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008619:Mepivacaine / Q000009:adverse effects*; D009638:Norepinephrine / Q000009:adverse effects*; D009669:Nose Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D014792:Visual Acuity / Q000187:drug effects; D014794:Visual Fields / Q000187:drug effects
D000779:Anesthetics, Local; D008619:Mepivacaine; D009638:Norepinephrine
Passagere Visusminderung durch Scandicain mit Arterenol-Zusatz bei Basaliom-Exzision am Nasenflügel.