Postoperative nausea and vomiting (PONV) is a common complaint after plastic and reconstructive surgery. Transdermal scopolamine is a commonly used agent for prevention of PONV. Anisocoria from transdermal scopolamine use is an adverse effect that has not been reported in the plastic surgery literature. We present a series of 3 craniofacial patients in which ipsilateral mydriasis occurred and spontaneously resolved after removal of the scopolamine patch. Given the various causes and potentially grave implications of unilateral mydriasis, we discourage the use of transdermal scopolamine in craniofacial surgery, and especially in orbital surgery. However, if transdermal scopolamine is decided to be used for PONV prophylaxis, we recommend educating the patient, the operating room staff, and the surgical team regarding this potential adverse effect and to avoid finger-to-eye contamination after patch manipulation.
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Article Synopsis
- Transdermal scopolamine applied to the area behind the ear is effective in reducing drooling in rats, with different application sites influencing its effectiveness.
- The study found that applying scopolamine ointment directly over the salivary glands resulted in a more significant reduction in saliva volume compared to applying it on the back.
- Higher concentrations of scopolamine were detected in the salivary glands when the ointment was applied over them, indicating that this method may be an efficient treatment option for drooling.
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