title: A double-blind randomized prospective study comparing prilocaine versus ropivacaine in upper blepharoplasty.
abstract: BACKGROUND
  Upper blepharoplasties are a common procedure in plastic surgery. This procedure can be performed effectively under local anesthesia with or without sedation. The ideal local anesthetic should cause less intraoperative bleeding and less postoperative edema. Our study aimed to show the difference between the two local anesthetics 1% prilocaine (Xylonaest) in combination with epinephrine 1:100,000 and ropivacaine (Naropin) in combination with epinephrine 1:100,000 including sodium chloride, particularly in regard to swelling and bleeding in patients undergoing upper blepharoplasties.
  
  
  METHODS
  In this double-blind, prospective, randomized study, 31 patients between March 2014 and September 2014 were included. The anesthetic agents used in all cases were 1% prilocaine (Xylonaest) in combination with epinephrine 1:100,000 for one side and ropivacaine consisting of 10-mg Naropin, 5-ml sodium chloride, and 1-ml epinephrine for the other side. The data presented in this study were collected by one of the surgeons performing the surgery. Intraoperative bleeding and postoperative edema were both calculated using a score of five points for each.
  
  
  RESULTS
  The average bleeding tendency was 3.39 for prilocaine and 1.71 for local ropivacaine, showing a significant difference (p < 0.0001) between both local anesthetics in bleeding tendency. There was also a significant minor swelling at all times on the side on which ropivacaine was used.
  
  
  CONCLUSIONS
  In our study, we demonstrated that ropivacaine (Naropin) has less intra- and postoperative side effects including swelling and bleeding compared with prilocaine (Xylonaest).
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Ensat
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria. Electronic address: kl.heinrich@bbsalz.at.
authors.forename: Klemens
authors.initials: K
authors.lastname: Heinrich
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria; Department of Plastic Surgery, Alexandria Faculty of Medicine, Egypt.
authors.forename: Hassan Mahmoud
authors.initials: HM
authors.lastname: Kholosy
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Wimbauer
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
authors.forename: Michaela
authors.initials: M
authors.lastname: Hladik
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brüder, Teaching hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
authors.forename: Gottfried
authors.initials: G
authors.lastname: Wechselberger
mesh_terms: D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D019882:Blepharoplasty / Q000379:methods*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D004311:Double-Blind Method; D004487:Edema / Q000139:chemically induced; D004837:Epinephrine; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000139:chemically induced; D011318:Prilocaine; D011446:Prospective Studies; D000077212:Ropivacaine; D016896:Treatment Outcome
chemical_list: D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D011318:Prilocaine; D000077212:Ropivacaine; D004837:Epinephrine
keywords: Blepharoplasty; Local anesthetic; Ropivacaine; Upper eyelid