Application of painless anesthesia in eyelid plastic surgery

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Objective To study the feasibility of applying ketamine and propofol for anesthesia in eyelid plastic surgery. Methods A total of 120 young female patients were enrolled. They underwent both eyelid plasty combined with medial canthoplasty. Sixty volunteers served randomly as clinical trail group and the rest as the control group. In clinical trail group, intravenous ketamine(0.40-0.55 mg/kg)and propofol (0.40-0.55 mg/kg) were given slowly before operation. When the recipients lost consciousness, the operator injected local anesthetic mixture into the subcutaneous eyelid. The mixture comprised 2% lidocaine, 10% ropivacaine (Volume 1∶1) and epinephrine (100 000∶1). The control group was given local anesthesia. Numeric pain rating scale(NRS) was used to record the recipients’ pain score during the local injection, 1 h, 2 h, 6 h, 12 h and 24 h after surgery. The difference of patients’ pain score between the two groups was not statistically significant. The adverse reactions during and after surgery were recorded. Results There was significant difference between the two groups in the severity of pain during the local injection, 1 h, 2 h, 6 h following surgery. The rates of adverse reactions such as nausea and vomiting in clinical trail group were lower. Conclusion Intravenous ketamine and propofol before the eyelid plastic surgery is effective for sedation and analgesic during and after surgery. It is worthy of clinical promotion because of safety, painlessness and less adverse events. Key words: Anesthesia, painless; Ketamine; Propofol; Plastic surgery, eyelid; Pain scale