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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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Local Anesthetics: Common Agents and Their Applications01:23

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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
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Accessory Structures of the Eye01:17

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Optical perception, or vision, is an extraordinary sense dependent on converting light signals received via the ocular organs. These organs, known as eyes, are securely positioned within the bony cavities of the skull, called orbits. The orbits serve a dual purpose: a protective shield for the ocular globes and a stable attachment point for the soft ocular tissues. The eye's external protective mechanisms include the eyelids, which are edged with lashes that act as a barrier against foreign...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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Regional Nerve Block Anesthesia in Upper Blepharoplasty.

Cheng-Chun Wu1, Su-Ben Tsao2, Yueh-Ming Lin3,4,5

  • 1Department of Plastic and Reconstructive Surgery, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan.

Aesthetic Plastic Surgery
|December 8, 2025
PubMed
Summary

Regional nerve block anesthesia offers a superior alternative for upper blepharoplasty, reducing complications like swelling and pseudoptosis. This method enhances surgical assessment and patient recovery compared to traditional local anesthesia.

Keywords:
BlepharoplastyLocal anesthesiaPseudoptosisRegional nerve blockUpper eyelid anesthesia

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Area of Science:

  • Ophthalmology
  • Plastic Surgery
  • Anesthesiology

Background:

  • Traditional local anesthesia for upper blepharoplasty causes eyelid swelling, distortion, and pseudoptosis, complicating surgical assessment and recovery.
  • Local anesthesia also increases injection pain and prolongs recovery time post-procedure.
  • Regional nerve block anesthesia avoids direct injection into the eyelid, mitigating these adverse effects.

Purpose of the Study:

  • To detail a novel regional nerve block anesthesia technique for upper blepharoplasty.
  • To evaluate the efficacy and safety of this anesthesia method in reducing complications.
  • To compare regional nerve block anesthesia with traditional local anesthesia in upper blepharoplasty outcomes.

Main Methods:

  • Retrospective review of 6,099 patients undergoing upper blepharoplasty with regional nerve block anesthesia (2009-2024).
  • Inclusion criteria: aesthetic blepharoplasty or ptosis repair; exclusion criteria: revision surgery for trauma or scars.
  • Data collected: perioperative photos, medical records, injection sites, anesthetic volume, pain response, and intra/postoperative effects.

Main Results:

  • Regional nerve block anesthesia was successfully administered to all 6,099 patients, with an average of 0.9 ml anesthetic solution per eyelid.
  • No instances of intra- or postoperative pseudoptosis were observed.
  • Patients reported satisfaction, experienced shorter recovery times, and noted no complications.

Conclusions:

  • Regional nerve block anesthesia is an effective alternative to local anesthesia for upper blepharoplasty.
  • This technique reduces eyelid swelling, distortion, bleeding, and anesthetic injection pain.
  • It significantly improves surgical assessment by preventing pseudoptosis and leads to faster patient recovery.