Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Hyperspectral and Laser Speckle Contrast Imaging for Monitoring the Effect of Epinephrine in Local Anesthetics in Oculoplastic Surgery

Bunke, Josefine LU ; Merdasa, Aboma LU ; Stridh, Magne ; Rosenquist, Pernilla ; Berggren, Johanna LU orcid ; Hernandez-Palacios, Julio E ; Dahlstrand, Ulf LU ; Reistad, Nina LU orcid ; Sheikh, Rafi LU orcid and Malmsjö, Malin LU (2022) In Ophthalmic Plastic and Reconstructive Surgery 38(5). p.462-468
Abstract

PURPOSE: Epinephrine is used in local anesthetics to induce vasoconstriction and thus reduce bleeding and prolong the anesthetic effect. Finding the optimal delay between the administration of the anesthetic and skin incision to ensure vasoconstriction and minimize bleeding is important and has recently become the subject of debate. This is the first study to assess blood perfusion and oxygen saturation (sO2) simultaneously in response to a local anesthetic containing epinephrine in human oculoplastic surgery.

METHODS: A local anesthetic consisting of lidocaine and epinephrine (20 mg/ml + 12.5 μg/ml) was injected in the eyelids of 9 subjects undergoing blepharoplasty. The perfusion and sO2 of the eyelids were monitored using laser... (More)

PURPOSE: Epinephrine is used in local anesthetics to induce vasoconstriction and thus reduce bleeding and prolong the anesthetic effect. Finding the optimal delay between the administration of the anesthetic and skin incision to ensure vasoconstriction and minimize bleeding is important and has recently become the subject of debate. This is the first study to assess blood perfusion and oxygen saturation (sO2) simultaneously in response to a local anesthetic containing epinephrine in human oculoplastic surgery.

METHODS: A local anesthetic consisting of lidocaine and epinephrine (20 mg/ml + 12.5 μg/ml) was injected in the eyelids of 9 subjects undergoing blepharoplasty. The perfusion and sO2 of the eyelids were monitored using laser speckle contrast imaging and hyperspectral imaging, respectively.

RESULTS: Laser speckle contrast imaging monitoring showed a decrease in perfusion over time centrally at the site of injection. Half-maximum effect was reached after 34 seconds, and full effect after 115 seconds, determined by exponential fitting. The drop in perfusion decreased gradually further away from the injection site and hypoperfusion was less prominent 4 mm from the injection site, with a spatially dependent half-maximum effect of 231 seconds. Hyperspectral imaging showed only a slight decrease in sO2 of 11 % at the injection site.

CONCLUSIONS: The optimal time delay for skin incision in oculoplastic surgery is approximately 2 minutes after the injection of lidocaine with epinephrine. Longer delay does not lead to a further decrease in perfusion. As sO2 was only slightly reduced after injection, the results indicate that the use of epinephrine is safe in the periocular region.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Ophthalmic Plastic and Reconstructive Surgery
volume
38
issue
5
pages
462 - 468
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:35470293
  • scopus:85138128826
ISSN
1537-2677
DOI
10.1097/IOP.0000000000002163
language
English
LU publication?
yes
additional info
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
id
e0363abc-809a-4202-bc21-b22150e61874
date added to LUP
2022-04-28 06:33:18
date last changed
2024-06-13 17:15:50
@article{e0363abc-809a-4202-bc21-b22150e61874,
  abstract     = {{<p>PURPOSE: Epinephrine is used in local anesthetics to induce vasoconstriction and thus reduce bleeding and prolong the anesthetic effect. Finding the optimal delay between the administration of the anesthetic and skin incision to ensure vasoconstriction and minimize bleeding is important and has recently become the subject of debate. This is the first study to assess blood perfusion and oxygen saturation (sO2) simultaneously in response to a local anesthetic containing epinephrine in human oculoplastic surgery.</p><p>METHODS: A local anesthetic consisting of lidocaine and epinephrine (20 mg/ml + 12.5 μg/ml) was injected in the eyelids of 9 subjects undergoing blepharoplasty. The perfusion and sO2 of the eyelids were monitored using laser speckle contrast imaging and hyperspectral imaging, respectively.</p><p>RESULTS: Laser speckle contrast imaging monitoring showed a decrease in perfusion over time centrally at the site of injection. Half-maximum effect was reached after 34 seconds, and full effect after 115 seconds, determined by exponential fitting. The drop in perfusion decreased gradually further away from the injection site and hypoperfusion was less prominent 4 mm from the injection site, with a spatially dependent half-maximum effect of 231 seconds. Hyperspectral imaging showed only a slight decrease in sO2 of 11 % at the injection site.</p><p>CONCLUSIONS: The optimal time delay for skin incision in oculoplastic surgery is approximately 2 minutes after the injection of lidocaine with epinephrine. Longer delay does not lead to a further decrease in perfusion. As sO2 was only slightly reduced after injection, the results indicate that the use of epinephrine is safe in the periocular region.</p>}},
  author       = {{Bunke, Josefine and Merdasa, Aboma and Stridh, Magne and Rosenquist, Pernilla and Berggren, Johanna and Hernandez-Palacios, Julio E and Dahlstrand, Ulf and Reistad, Nina and Sheikh, Rafi and Malmsjö, Malin}},
  issn         = {{1537-2677}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{5}},
  pages        = {{462--468}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Ophthalmic Plastic and Reconstructive Surgery}},
  title        = {{Hyperspectral and Laser Speckle Contrast Imaging for Monitoring the Effect of Epinephrine in Local Anesthetics in Oculoplastic Surgery}},
  url          = {{http://dx.doi.org/10.1097/IOP.0000000000002163}},
  doi          = {{10.1097/IOP.0000000000002163}},
  volume       = {{38}},
  year         = {{2022}},
}