Hemodynamic and Clinical Outcomes of Local Anesthetic Use in Patients Undergoing External Dacryocystorhinostomy

The aim of this study is to evaluate the effect of using local anesthesia at the incision area during external dacryocystorhinostomy (E-DCR) to control intraoperative hemorrhage on hemodynamic and clinical outcomes.

All patients aged 18 years and older who underwent external dacryocystorhinostomy at Niğde Training and Research Hospital between January 2024 and March 2025 with a diagnosis of primary acquired nasolacrimal duct obstruction were included in the study. Patients included in the study were randomly divided into 2 groups: those who used local anesthesia (20 mg/mL lidocaine hydrochloride and 0.0125 mg/mL epinephrine, 3 mL) at the incision site during surgery (group 1) and those who did not (group 2). Hemodynamic parameters were measured at three different time points: before osteotomy, during osteotomy, and after osteotomy. Postoperative pain was assessed using the visual analog scale (VAS) score at 0, 2, 6, and 12 hours postoperatively.

A total of 39 patients were included in the study. While the average intraoperative hemorrhage was 4.2±1.0 mL in group 1, 6.6±1.2 mL in group 2. This difference observed between the groups was statistically significant ( P <0.001). The average patient satisfaction score was 8.4±0.8 in group 1 and 7.4±0.7 in group 2, and significantly higher in group 1 ( P <0.001).

In conclusion, when the appropriate anatomical approach is used during E-DCR, local anesthesia improves visibility of the surgical area. It also prevents unnecessary cauterization and may increase postoperative patient satisfaction. This approach is a safe and effective method for patients with acquired nasolacrimal duct obstruction.