RESUMEN
Introdução: A anestesia peribulbar para blefaroplastias inferiores foi utilizada com sucessoem pacientes selecionados nos últimos 9 anos. Esta técnica é amplamente utilizada nosprocedimentos oftalmológicos, porém ainda não havia sido especificamente indicada paraas blefaroplastias. Métodos: Foram submetidos a blefaroplastias com bloqueio peribulbarinferior 788 pacientes com idade variando entre 36 e 77 anos, 623 (79%) eram mulheres e165 (21%) homens. Resultados: Nenhum dos pacientes tratados queixou-se de dor ou desconfortodurante ou após a cirurgia. Quemose imediata (17 casos - 2,2%) após a anestesiaperibulbar inferior, hematoma orbital (3 casos - 0,4%) e diplopia foram as complicaçõesobservadas. Conclusões: A anestesia peribulbar inferior para as blefaroplastias ofereceresultados surpreendentes. As cirurgias são realizadas de forma indolor, permitindo aos pacientesum estado de relaxamento completo, proporcionando ao cirurgião um procedimentode realização mais simples e confortável.
Background: The peribulbar anesthesia for inferior blepharoplasties was employed successfullyin selected patients over the last 9 years. This technique is largely accepted forophthalmologic procedures but yet not specifically employed for blepharoplasties. Methods:788 patients with ages ranging from 36 to 77 years old were submitted to inferior peribulbaranesthesia for blepharoplasty procedures, 623 (79%) were female and 165 (21%) were male.Results: None of our treated patients complained of pain or discomfort during or after thesurgical procedure. Immediate chemosis after inferior peribulbar anesthesia was observed in17 (2.2%) cases, orbital hematoma was observed in 3 cases (0.4%) and diplopya or a slightimaging distortion may occur after inferior peribulbar anesthesia, lasting a few hours. Conclusions:The inferior peribulbar anesthesia for blepharoplasties offers surprising results.The surgical procedures are performed pain-free, leaving the patients completely relaxed,allowing an easier surgical procedure.
Asunto(s)
Humanos , Masculino , Adulto , Femenino , Persona de Mediana Edad , Anestesia , Blefaroplastia , Procedimientos Quirúrgicos Oftalmológicos , Párpados/cirugía , Métodos , Pacientes , Técnicas y Procedimientos DiagnósticosRESUMEN
BACKGROUND: Peribulbar anesthesia for inferior blepharoplasty was used successfully in 788 selected cases over the past 9 years. This technique is largely accepted for ophthalmologic procedures, but is not yet specifically used for blepharoplasty. METHODS: In the past 9 years, 788 patients ages 36 to 77 years were submitted to inferior peribulbar anesthesia for blepharoplasty procedures. Of these patients, 623 (79%) were women and 165 (21%) were men. The anesthetic procedure is performed using a needle introduced at the junction of the medial two-thirds and the lateral third of the inferior orbital rim (point A). With the patient staring forward, the needle is introduced through the lid at point A. It enters the orbital cavity just above the orbital floor periosteum until the globe equator is minimally trespassed (depth, approximately 31 mm). There, 3 ml of the local anesthetic solution (2% lidocaine + 0.5% bupivacaine) is slowly injected. RESULTS: None of our treated patients reported pain or discomfort during or after the surgical procedure. Immediately after inferior peribulbar anesthesia, chemosis was observed in 17 cases (2.2%) and orbital hematoma in 3 cases (0.4%). Diplopia, or a slight imaging distortion lasting a few hours may occur after inferior peribulbar anesthesia. CONCLUSION: Inferior peribulbar anesthesia for blepharoplasty offers surprising results. The surgical procedures are performed pain free, leaving the patients completely relaxed and allowing an easier surgical procedure. This technique should be performed only by highly skilled anesthesiologists or surgeons with a perfect knowledge of the complex orbital anatomy.