Comparative clinical trial of topical anesthetic agents in cataract surgery

Soliman, Mahmoud M.; Macky, Tamer A.; Samir, M.Khaled

doi:10.1016/j.jcrs.2003.12.034

Cited by 52 publications

(15 citation statements)

References 20 publications

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“…Bupivacaine 0.5% eyedrops alone did not provide satisfactory topical anesthesia [unpubl. observation], and others have shown that bupivacaine alone seems to be in fact less effective than lidocaine gel [10]. In order to provide better anesthesia and possibly analgesia, a combination of bupivacaine 0.5%, oxybuprocaine 1% and diclofenac eyedrops was used, and the eyedrops combination was administered 4 times prior to cataract surgery.…”

Section: Discussionmentioning

confidence: 99%

Lidocaine Gel versus Combined Topical Anesthesia Using Bupivacaine, Oxybuprocaine and Diclofenac Eyedrops in Cataract Surgery

Thill

Zeitz²,

Richard³

et al. 2005

Ophthalmologica

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Purpose: To assess the safety and efficacy of two topical anesthesia regimes for cataract surgery. Methods: 21 patients received a combination of 4 times bupivacaine 0.5, oxybuprocaine and diclofenac eyedrops, 18 patients were given a single topical application of lidocaine gel 2%. A single intracameral injection of lidocaine 1% was administered to all subjects. Results: The extent to which the surgeon was bothered by patient motility was graded as low in about two thirds of all procedures. Patients reported lower intraoperative pain levels with a single application of lidocaine gel supplemented with intracameral lidocaine than with a fourfold application of the combination topical anesthesia plus intracameral anesthesia. Conclusions: A single application of lidocaine gel 2% combined with intracameral anesthesia provides at least as good analgesia than multiple administration of combined topical anesthesia supplemented with intracameral anesthesia and is equally safe.

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Section: Discussionmentioning

confidence: 99%

Lidocaine Gel versus Combined Topical Anesthesia Using Bupivacaine, Oxybuprocaine and Diclofenac Eyedrops in Cataract Surgery

Thill

Zeitz²,

Richard³

et al. 2005

Ophthalmologica

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“…The safety and utility of the jelly formulation has been studied and demonstrated in several studies. [14] Jelly provides comparable[1516] and possibly superior anesthesia,[1718] wets the corneal surface, aids in pupillary dilatation without the use of sympathomimetics or parasympatholytic agents. [14] Adding intracameral lignocaine solution aids in increasing patient comfort and is safe and assists in pupillary dilatation.…”

Section: Methodsmentioning

confidence: 99%

Cataract surgery under topical anesthesia: Gender-based study of pain experience

2010

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Background:Pain perception, expression, tolerance, and the healthcare provider’s evaluation and management of pain are affected by the gender of the patient. To the best of our knowledge, there is lack of gender-based evaluation of pain during cataract surgery under topical anesthesia.Aims:This study has been initiated to evaluate and determine pain experience during cataract surgery under topical anesthesia and to study the gender-based differences of the same.Settings and Design:Hospital-based study involving cataract surgery under topical anesthesia using standard cataract surgery. It was an interventional comparative case series.Materials and Methods:One hundred and sixty patients were included in four groups, according to the gender and choice of surgery. Patients underwent either phacoemulsification with foldable intra ocular lens (IOL) or manual small incision cataract surgery with rigid IOL under topical anesthesia. Patients ranked their pain experience on VAS scale after the surgery and the surgeon recorded the ease/difficulty accordingly using a questionnaire.Statistical Analysis Used:MedCalc version 10.2.0.0 (www.medcalc.be) for windows was used to analyze the results. Analysis of variance (ANOVA) test and Kruskal-Walis test were used to analyze the data.Results:The overall visual analog scale (VAS) score was 0.8 (SD 1.3 range 0-8), with no statistical difference among the groups (P=0.5). The average surgeon’s score was 3.3 (SD 0.71 range 3-7), with no statistical difference between the groups (P=0.37).There were no sight threatening complications during the surgery in any group.Conclusions:The outcome of the study demonstrates that the patients undergoing cataract surgery under topical anesthesia perceive comparable pain and discomfort irrespective of their gender.

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“…Soliman et al reported that 73.3% of patients that received topical 0.4% benoxinate and 10% of patients that received topical 0.5% bupivacaine during phacoemulsification surgery had severe to unbearable pain which led to addition of subtenon lidocaine injection [4]. In our study, seven patients (14.2%) experienced severe to unbearable pain which necessitated intracameral lidocaine injection.…”

Section: Discussionmentioning

confidence: 60%

“…The three most common methods of applying topical anesthesia are by eye drops, by eye drops with intracameral lidocaine injection, and in gel form [3, 4]. Topical anesthesia by eye drops is a noninvasive method, but in some cases it may provide insufficient analgesia and require an additional intracameral lidocaine injection [5].…”

Section: Introductionmentioning

confidence: 99%

Topical Anesthesia for Cataract Surgery: The Patients' Perspective

Apil

Kartal

Ekinci

et al. 2014

Pain Research and Treatment

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Purpose. To evaluate the analgesic efficacy of 0.5% propacaine hydrochloride as topical anesthesia during phacoemulsification surgery. Methods. Intraoperative pain intensity was assessed using a 5-category verbal rating scale during each of three surgical stages. Pain scores from each surgical stage and total pain scores were compared for the factors of patient age, gender, cataract laterality, and type. Results. In comparison of cataract type subgroups, the mean total pain scores and mean stage 2 pain scores in both white mature cataract (WMC) and corticonuclear plus posterior subcapsular cataract (CN + PSC) groups were significantly higher than in the PSC-only (PSC) group (P < 0.05). Conclusion. Phacoemulsification with topical anesthesia is not a completely painless procedure. Pain intensity varies with cataract type and stage of surgery.

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Comparative clinical trial of topical anesthetic agents in cataract surgery

Abstract: Lidocaine gel was a better topical anesthetic agent than bupivacaine and benoxinate drops. Bupivacaine drops were effective in providing deep topical anesthesia.

Cited by 52 publications

References 20 publications

Lidocaine Gel versus Combined Topical Anesthesia Using Bupivacaine, Oxybuprocaine and Diclofenac Eyedrops in Cataract Surgery

Lidocaine Gel versus Combined Topical Anesthesia Using Bupivacaine, Oxybuprocaine and Diclofenac Eyedrops in Cataract Surgery

Cataract surgery under topical anesthesia: Gender-based study of pain experience

Topical Anesthesia for Cataract Surgery: The Patients' Perspective

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