Efficacy of Local Anesthesia during External Dacryocystorhinostomy with 1:200,000 Adrenaline Versus 1:50,000 Adrenaline

Purpose: To compare the efficacy of local anesthesia during Dacryocystorhinostomy using xylocaine with1:200,000 adrenaline versus 1:50,000 adrenaline.Study Design: Quasi experimental study.Place and Duration of Study: DHQ Hospital, Dera Ismail Khan, from January to December 2019.Material and Methods: We compared two different formulations of local anesthesia duringDacryocystorhinostomy in terms of efficacy of per-operative pain, bleeding and effectiveness of anesthesia. 50patients fulfilling our inclusion criteria were divided in two groups each containing 25 patients. In group A patientsunderwent Dacryocystorhinostomy under local anesthesia using Bupivacaine and the commercially availablexylocaine with 1:200,000 adrenaline while patients in the group B underwent surgery using Bupivacaine,Xylocaine with 1:50,000 adrenaline. Per-operative pain, bleeding and effectiveness of anesthesia were measuredon a numeric scale. Means of pain score, bleeding score and anesthesia effectiveness score were computed andwere compared.Results: In group A, 84% patients were females and 16% were male. In group B, 80% were females and 20%were males. Mean age of patients was 41.04 ± 6.84 and 40.80 ± 8.563 years in group A and B respectively. Meanpain score in group A was 2.20 while in group B was 1.72. Mean bleeding score in Group A was 1.84 while ingroup B was 1.24. Mean Anesthesia effectiveness score in group A was 2.08 while in group B was 2.76.Conclusion: Local anesthesia with concentrated adrenaline (in patients with no cardiac disease or other majorco-morbidity) provides a better control of per-operative pain, bleeding and better anesthesia