The Change of Severity of Epiblepharon after Induction of Total Intravenous Anesthesia Without Muscle Relaxant

Purpose: To investigate the changes of epiblepharon by evaluating the severity of epiblepharon before and after induction of general anesthesia (GA) with a muscle relaxant and total intravenous anesthesia (TIVA) without a muscle relaxant.Methods: Thirteen pediatric patients (26 eyes) underwent surgery for epiblepharon under GA using a muscle relaxant and 19 pediatric patients (38 eyes) underwent surgery for epiblepharon under TIVA without a muscle relaxant. The severity of epiblepharon in each eye was scored according to skin-fold height (scored 1-4) and area of ciliocorneal touch (scored 1-3) while the patient was in the supine position before induction and after induction of GA.Results: Skin-fold height scores and ciliocorneal touch area scores decreased after induction of GA with a muscle relaxant (skin-fold height score before GA: 2.42 +/- 0.86, after GA: 1.87 +/- 0.88 p-value < 0.001; ciliocorneal touch area score before GA: 2.05 +/- 0.70, after GA: 1.61 +/- 0.68, p-value < 0.001). In the TIVA group, skin-fold height scores and ciliocorenal touch area scores were not statistically different before and after GA (skin-fold height score before GA: 2.23 +/- 1.18, after GA: 2.38 +/- 1.10, p-value = 0.212; ciliocorneal touch area score before GA: 2.06 +/- 0.74, after GA: 1.94 +/- 0.80, p-value = 0.161).Conclusions: The change of epiblepharon severity was significantly reduced by induction of TIVA without a muscle relaxant and there was no recurrence of epiblepharon 3 months after surgery. When using TIVA without a muscle relaxant, the change of epiblepharon severity was reduced and thus, this method can help prevent its undercorrection.