Botulinum toxin injection under intravenous ketamine anesthesia can safely be used for children. Ketamine anesthesia may be associated with side effects, namely hallucinations and sleep disturbances.

Fifty patients undergoing routine phacoemulsification using a clear corneal 2.8-mm incision were randomly assigned to receive 5 ml 1% lidocaine or 5 ml 2% lidoocaine, using a one-quadrant sub-Tenon's injection. A blinded observer subsequently assessed ocular akinesia at 30 s and 1, 3, 5 and 10 min, using a validated scoring system. Changes in the ocular motility scores were then compared with t-tests, chi-squared test or Mann-Whitney U test, using SPSS. ResultsThere was no significant difference in the ocular motility scores at 30 s and 1 min in both groups. However by 3 min, patients in the 2% group demonstrated significantly better akinesia (Table 1). The difference was maintained at 5 and 10 min. Onset of akinesia was also faster in this group. DiscussionWe found that 2% lidocaine provides a better and faster onset of akinesia in patients undergoing phacoemulsification under sub-Tenon's anaesthesia.

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