[Use of EMLA cream and ropivacaine in dacryocystorhinostomy with locoregional anesthesia and sedation].

Objective: To assess the usefulness of locoregional anesthesia and sedation as an alternative to general anesthesia for dacryocystorhinostomy.
Patients and Method: Study of 20 patients undergoing dacryocystorhinostomy between April and October 1999. All the processes were carried out by the same surgeon under locoregional anesthesia plus sedation. We used EMLA cream to anesthetize nasal mucosa and ropivacaine for infiltration and anesthetic block; midazolam and fentanyl were used for sedation.
Results: Surgery was possible in all cases under locoregional anesthesia with no noteworthy complications. Anesthesia in the zone was good (assessed by hemodynamic changes and by asking the patient during and after the process). The experience was described as good by 70% of patients and poor by only 5%; the surgeon emphasized that bleeding was less than when the procedure is performed under general anesthesia. All patients were released within 24 hours.
Conclusions: Using locoregional anesthesia and sedation for dacryocystorhinostomy is safe and effective and provides a valid alternative to general anesthesia. We suggest using EMLA cream in the nasal dressing and ropivacaine for infiltration. The process can be considered major outpatient surgery.