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Foto av Nina Reistad

Nina Reistad

Universitetslektor

Foto av Nina Reistad

Optimal Epinephrine Concentration and Time Delay to Minimize Perfusion in Eyelid Surgery : Measured by Laser-Based Methods and a Novel Form of Extended-Wavelength Diffuse Reflectance Spectroscopy

Författare

  • Rafi Sheikh
  • Ulf Dahlstrand
  • Khashayar Memarzadeh
  • Jonas Blohmé
  • Nina Reistad
  • Malin Malmsjö

Summary, in English

OBJECTIVE:: This study investigates the hypoperfusion effects of epinephrine in local anesthesia in eyelid surgery. A novel form of extended-wavelength diffuse reflectance spectroscopy was evaluated. METHODS:: Blood perfusion in porcine eyelid flaps was measured using laser Doppler velocimetry and laser speckle contrast imaging, whereas the tissue response was measured using diffuse reflectance spectroscopy with a broad spectrum (450–1550 nm). Epinephrine was either injected cumulatively, 0.1 (1:10,000,000), 1.0 (1:1,000,000), 10 (1:100 000), and 100 μg/ml (1:10 000), to determine the dose–response relation, or given as a single dose (10 μg/ml). Control experiments were performed with saline or lidocaine. RESULTS:: Increasing concentrations of epinephrine resulted in a gradual decrease in tissue perfusion, measured by laser Doppler velocimetry and laser speckle contrast imaging, approaching a minimum after the injection of 10 μg/ml. Similar tissue response was observed with diffuse reflectance spectroscopy. The time from the injection of epinephrine (10 μg/ml) to the stabilization of hypoperfusion was 75 seconds. After administration of 10 μg/ml epinephrine, about 20% of the blood perfusion remained, supporting the use of epinephrine in eyelid flaps with a narrow pedicle. CONCLUSIONS:: 10 μg/ml epinephrine appears to be adequate for vasoconstriction before oculoplastic surgery. Incisions need only be delayed for about 1 minute. Extended-wavelength diffuse reflectance spectroscopy appears to be a promising technique for monitoring the tissue response following changes in blood perfusion in plastic surgery reconstructions. However, more rigorous validation of the technique is required before it can be implemented in clinical practice.

Avdelning/ar

  • Forskargruppen för oftalmologisk avbildning
  • Oftalmologi, Lund
  • Atomfysik

Publiceringsår

2018

Språk

Engelska

Sidor

123-129

Publikation/Tidskrift/Serie

Ophthalmic Plastic and Reconstructive Surgery

Volym

34

Issue

2

Dokumenttyp

Artikel i tidskrift

Förlag

Lippincott Williams & Wilkins

Ämne

  • Ophthalmology

Status

Published

Projekt

  • Flap monitoring during oculoplastic reconstructive surgery using new non-invasive imaging techniques
  • Identifying periorbital tumor margins using new non-invasive imaging techniques
  • Perfusion Monitoring During Oculoplastic Reconstructive Surgery - Opportunities for Optimization of Surgical Techniques

Forskningsgrupp

  • Ophthalmology Imaging Research Group

ISBN/ISSN/Övrigt

  • ISSN: 0740-9303