title: A randomised double-blinded crossover study comparing pain during anaesthetising the eyelids in upper blepharoplasty: First versus second eyelid and lidocaine versus prilocaine.
abstract: OBJECTIVE
  The aim of this study was to investigate whether infiltration of the upper eyelid skin is less painful with prilocaine than with lidocaine.
  
  
  METHODS
  In 40 consecutive patients scheduled for bilateral upper blepharoplasty, one upper eyelid was anaesthetised with lidocaine with epinephrine and the other with prilocaine with felypressin. After injection of each upper eyelid, the patient scored the pain experienced on infiltration using a visual analogue scale (0-10). In addition, the surgeon scored the need for reinjection during the operation; differences in perioperative bleeding; and degree of oedema, erythema and haematoma before discharge on a four-point rating scale (no, minimal, moderate or severe).
  
  
  RESULTS
  Pain scores were significantly lower in upper eyelids injected with lidocaine than in those injected with prilocaine (p = 0.036). In addition, scores for oedema, erythema and haematoma were significantly lower in upper eyelids anaesthetised with lidocaine than in those anaesthetised with prilocaine (respectively, p = 0.001, p = 0.004 and p = 0.000).
  
  
  CONCLUSIONS
  Compared with prilocaine with felypressin, lidocaine with epinephrine is significantly less painful in anaesthetising the upper eyelids; gives significantly less postoperative oedema, erythema and haematoma; and provides better haemostasis during upper blepharoplasty.
  
  
  METHODS
  This was a level II, randomised double-blinded crossover study.
authors.affiliation: Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Shariselle M W
authors.initials: SM
authors.lastname: Pool
authors.affiliation: Department of Anaesthesiology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Michel M R F
authors.initials: MM
authors.lastname: Struys
authors.affiliation: Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, The Netherlands; Bergman Clinics, Private Clinics for Aesthetic Surgery, Groningen, Heerenveen and Zwolle, The Netherlands. Electronic address: b.van.der.lei@umcg.nl.
authors.forename: Berend
authors.initials: B
authors.lastname: van der Lei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D019882:Blepharoplasty / Q000009:adverse effects / Q000379:methods*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005143:Eyelids / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis*; D010865:Pilot Projects; D011318:Prilocaine / Q000008:administration & dosage*; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D011318:Prilocaine; D008012:Lidocaine
keywords: Anaesthesia; Blepharoplasty; Pain; Upper eyelid