Blepharoplasty is a commonly performed surgical procedure for upper eyelid correction, addressing both functional impairments and aesthetic concerns. This study aimed to evaluate postoperative pain and compare the efficacy of different local anesthetic agents in patients undergoing upper blepharoplasty. A total of 100 patients (65 females, 35 males; mean age 57.3 ± 6.4 years) who underwent upper eyelid blepharoplasty were randomly divided into three groups based on the anesthetic agent used: lidocaine 2% with epinephrine 1:100,000 (group 1), articaine 4% with epinephrine 1:100,000 (group 2), and bupivacaine 0.5% with epinephrine 1:200,000 (group 3). In each patient, 1.5 mL of the selected anesthetic was applied per eye via local infiltration along the supratarsal crease and lateral canthus. Following the application, a waiting period of 5 minutes was observed to allow for optimal anesthetic effect and vasoconstriction. Pain intensity was assessed using the Visual Analog Scale (VAS) at 6, 24, and 48 hours postoperatively. Results showed that patients in the bupivacaine group reported significantly lower pain scores at all time points compared to the lidocaine and articaine groups. At 6 hours post-surgery, 65% of patients in the lidocaine group reported mild to moderate pain (VAS 3–5), compared to 58% in the articaine group and 40% in the bupivacaine group. By 48 hours, pain levels decreased significantly across all groups, with the bupivacaine group maintaining the lowest pain scores. The findings suggest that bupivacaine, due to its longer duration of action, provides more effective postoperative pain control following upper blepharoplasty. These results highlight the importance of selecting an appropriate anesthetic agent and allowing sufficient time for its effect to improve patient comfort and recovery outcomes.

Dr. Margita Lucic is an anesthesiologist at the University Eye Hospital, Clinical Centre of Serbia. She has extensive experience in perioperative care and pain management, particularly in ophthalmic surgeries such as blepharoplasty and ocular tumor procedures. Dr. Lucic is dedicated to optimizing patient outcomes through the use of innovative anesthetic techniques, with a focus on improving postoperative comfort and recovery. She actively participates in clinical research and contributes to advancements in anesthesia protocols for ophthalmic procedures.