Regional nerve block of the upper eyelid in oculoplastic surgery.

PURPOSE: To establish the efficacy of a regional nerve block of the upper eyelid and its effect on levator motor function.

METHODS: Forty-one patients underwent surgery on 54 upper eyelids by one surgeon, after administration of a regional nerve block at the supraorbital notch. The amount of pain experienced by patients due to the local anesthetic injection and surgery was determined by using visual analogue scores. The effect of the local anesthetic injection on levator function was determined by comparing the measured levator function prior to and following administration. Any complications attributable to the regional sensory nerve block were recorded.

RESULTS: Ninety-two percent of patients found the injection painless, and the rest reported negligible pain. The mean pain score for the injection was 2 (SD 1.3, range 0-6). The mean pain score for the surgery was 0.3 (SD 0.6, range 0-3). No significant difference was found in levator function prior to and following the injection (pre-function: 14.4 mm, post-function: 13.4 mm, p=0.01). One patient had hematoma formation at the site of injection.

CONCLUSIONS: A regional nerve block of the upper eyelid achieves effective sensory anesthesia,without compromising motor function. This helps in an accurate assessment of intraoperative height during upper lid surgery.