title: [Eyelid necrosis after injection of lidocaine with epinephrine].
abstract: Four patients (two women aged 50 and 67 years, a 36-year-old man, and a 5-year-old child) presented with necrosis of the eyelid after local anesthesia using 2% lidocaine with epinephrine. In three cases, the anesthesia was administered prior to suturing an eyelid laceration, and the necrosis involved the upper lid; in one case, the anesthesia was administered prior to temporal artery biopsy. Surgical debridement of the necrotic tissue was performed in all cases. Three patients developed a bacterial superinfection treated with systemic antibiotics with good results. Necrosis of the eyelid is a rare complication occurring after local anesthesia using lidocaine with epinephrine. Most dermatologists refrain from use of epinephrine with local anesthetics for digital blocks. Necrosis is due to prolonged vasoconstriction of arteries. It is observed especially commonly in patients at increased risk (arteritis, Raynaud's phenomenon and severe microvascular diseases). In the eyelid, few cases have been reported.
authors.affiliation: Service d'ophtalmologie, CHU Farhat Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie. salahyakoubi@yahoo.fr
authors.forename: S
authors.initials: S
authors.lastname: Yakoubi
authors.forename: L
authors.initials: L
authors.lastname: Knani
authors.forename: F
authors.initials: F
authors.lastname: Touzani
authors.forename: N
authors.initials: N
authors.lastname: Ben Rayana
authors.forename: F
authors.initials: F
authors.lastname: Krifa
authors.forename: H
authors.initials: H
authors.lastname: Mahjoub
authors.forename: M
authors.initials: M
authors.lastname: Ghorbel
authors.forename: F
authors.initials: F
authors.lastname: Ben Hadj Hamida
mesh_terms: D000328:Adult; D000368:Aged; D002675:Child, Preschool; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D005141:Eyelid Diseases / Q000139:chemically induced* / Q000175:diagnosis* / Q000601:surgery; D005143:Eyelids / Q000473:pathology*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced / Q000175:diagnosis
chemical_list: D004338:Drug Combinations; D008012:Lidocaine; D004837:Epinephrine