TREATMENT OF PERIORBITAL EDEMA WITH HUMAN CORTICOTROPIN-RELEASING FACTOR AFTER BLEPHAROPLASTY

BACKGROUND: This prospective study of 32 patients was undertaken to ev aluate the formation of postoperative periorbital edema after administ ration of human corticotropin-releasing factor (hCRF), Human corticotr opin-releasing. factor has strong antiedematous properties as a result of direct action on blood vessels independent of endocrine function a nd has been shown to have a positive effect on vascular permeability i n animal studies independent of corticosteroid effects. STUDY DESIGN: Human corticotropin-releasing factor was administered intravenously pr eoperatively to patients undergoing blepharoplasty in doses of 2, 4, a nd 8 mu g/kg body weight as a randomized, double-blind, placebo-contro lled study, The periorbital edema was measured by the use of a three-d imensional laser scanner to determine facial and eyelid volume changes at specified times postoperatively. RESULTS: Human corticotropin-rele asing factor was well tolerated when administered intravenously over a ten-minute period to healthy patients undergoing blepharoplasty. Mild transitory flushing and hypotension were the most common adverse even ts, Transient decreases in systolic and diastolic blood pressure and i ncreases in heart rate occurred at hCRF doses greater than 2 mu g/kg a nd were most prominent at 8 mu g/kg. The 8 mu g/kg. hCRF dose also sho wed a trend toward less postoperative edema but this was not statistic ally significant at the p<0.05 level, CONCLUSIONS: Human corticotropin -releasing factor appears to be safe for intravenous use in patients u ndergoing blepharoplasty; however, its efficacy in reducing postoperat ive edema as a single preoperative administration was not conclusively demonstrated in this study, Further research with a larger study popu lation and other dosing regimens is indicated.