Lidocaine/epinephrine

Excerpt

A 26-year-old man with nasal obstruction was scheduled to undergo septoplasty and right bullous concha resection under local anaesthesia. Following premedication, resection of the right middle bullous concha was performed under local anaesthesia. He then underwent submucoperichondrial infiltration of the left side of his nasal septum with a 1% lidocaine/1:100 000 epinephrine [adrenaline] product [Jetokainâ; dosage details incomplete]. After instillation, he experienced a burning sensation in the ipsilateral eye, with mydriasis and blurred vision. The operation was cancelled. Examination revealed lack of pupillary light reflexes in the affected eye. An hour later, mydriasis and blurred vision completely resolved. Repeat examination was normal.Author Comment"Mydriasis following the local anaesthetic injection and the rapid recovery may suggest vascular diffusion of the drug to the ophthalmic artery, affecting the branches of the 3^rd cranial nerve." …