role of lidocaine in oculoplastic surgery

[danielsong]

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During the eyelid surgery, we use lidocaine with epinephrine for local anesthesia.
Then, what is the role of lidocaine for the patients(ex. kids) under general anesthesia?
Only for the postop pain relief?
Why can't we use saline mixed with epinephrine instead of this?

 

[orbitsurgMD]

During the eyelid surgery, we use lidocaine with epinephrine for local anesthesia.
Then, what is the role of lidocaine for the patients(ex. kids) under general anesthesia?
Only for the postop pain relief?
Why can't we use saline mixed with epinephrine instead of this?

Depending on the patient and the choice of IV analgesics used in the general anaesthesia combination, it can have the double purpose of local anesthesia and hemostasis and, depending on the choice of anesthetics in the local mixture--lidocaine alone or lidocaine with bupivicaine (and bicarb sometimes), also have a postoperative analgesia effect.

The purpose of the epinephrine is to extend the duration of effect of the anesthetic injected, not so much for hemostasis, although that occurs also.

I would not use epinephrine alone unless I had reason to believe I had exceeded the maximum safe dose of lidocaine.

 

[MDEYES]

I asked the same question to my attending during surgery last week, and his response was 1. for hemostasis (epi effect) and 2. so we could practice how to do the injections