Upper eyelid anesthesia.

The aim of this study is to investigate whether infiltration of the upper eyelid with Citanest is less painful then infiltration of the upper eyelid with Xylocaine. If this hypothesis proves to be correct, then in the future Citanest can be used in every upper eyelid blepharoplasty in order to reduce the pain on infiltration of the upper eyelids.

Injecting the upper eyelids with the anesthetic is experienced as quite painful by most patients. The acidity of the commonly used anesthetic Xylocaine is assumed to be the (main) cause of the pain. Citanest, the standard local anesthetic in dentistry, has a higher pH then Xylocaine and could therefore lead to less pain during stunning of the upper eyelids in upper eyelid blepharoplasty.

After injection of each upper eyelid, the participant will be asked to score the pain experienced on infiltration. So this will be asked twice in total (on the day of operation).

All blepharoplasties will be performed by one of four plastic surgeons who work in the Bergman Clinics. In all participants one of the upper eyelids will be stunned 'standard' with Xylocaine 1%-Adrenaline (lidocainehydrochloride 10 mg/ml with epinephrine 5 µg/ml). The other upper eyelid will be injected with Citanest 3%-Octapressine (prilocainehydrochloride 30 mg/ml with felypressine 0,54 µg/ml). Drawing lots just before the operation will determine which upper eyelid will be injected with Xylocaine and which upper eyelid with Citanest.

For stunning, a 10 cc syringe is used with a 30G needle. Both anesthetics will be at room temperature, and are injected with a similar speed. In all participants, a volume of about 5 ml will be injected in each upper eyelid. If additional anesthetic is required or neccesary during the operation, this will be provided by the same anesthetic which is used initially.