Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial

Detalhes bibliográficos
Autor(a) principal: Andrade,Gabriel Costa de
Data de Publicação: 2015
Outros Autores: Carvalho,André Correa Maia de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos brasileiros de oftalmologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492015000100008
Resumo: Purpose: To compare the anesthetic effectiveness of topical proparacaine drops, subconjunctival lidocaine, and 2% lidocaine gel. Methods: Ninety-two patients undergoing intravitreal injections were randomized to 1 of 3 groups: proparacaine 0.5% drops (Group Drops), proparacaine 0.5% drops plus subconjunctival lidocaine (Group SC), or 2% lidocaine gel (Group Gel). Patients were asked to score their pain experience using a visual analog scale of 0 to 10 immediately following the injections and 10 min, 1 h, 6 h, and 24 h after the injections. Patients also graded the overall injection experience as Excellent, Very Good, Fair, Poor, or Awful. The physician evaluated the patients’ eye movement during intravitreal injection on 3 levels: (0) none or minimal, (1) not compromising the injection, and (2) compromising the injection. Results: The patients in Group Drops had the worst mean pain scores during the injection and 10 min after, with the highest occurrence of movements compromising the procedure (Grade 2; 38.7%). The patients in Group SC had a higher percentage of good experiences (37.9%) but a higher incidence of chemosis (16.7%). The patients in Group Gel had similar overall pain scores to Group Drops patients but a higher incidence of keratitis (19.4%). There was no statistically significant correlation between the use of aspirin or anticoagulants and the occurrence of hyperemia or hyposphagma. Conclusion: Subconjunctival lidocaine was most effective in preventing pain and eye movements during intravitreal injections. Although 2% lidocaine gel produced a good overall experience for the patients, the incidence of keratitis was very high (19.4%). Therefore, we do not recommend 2% lidocaine gel as the first anesthetic choice for intravitreal injections. There is no evidence to suspend the use of aspirin or other anticoagulants drugs prior to intravitreal injections.
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spelling Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trialEfficacyAnesthesiaPropoxycaine/administration & dosageLidocaine/ administration & dosageIntravitreal injectionsConjunctiva/drug effects Purpose: To compare the anesthetic effectiveness of topical proparacaine drops, subconjunctival lidocaine, and 2% lidocaine gel. Methods: Ninety-two patients undergoing intravitreal injections were randomized to 1 of 3 groups: proparacaine 0.5% drops (Group Drops), proparacaine 0.5% drops plus subconjunctival lidocaine (Group SC), or 2% lidocaine gel (Group Gel). Patients were asked to score their pain experience using a visual analog scale of 0 to 10 immediately following the injections and 10 min, 1 h, 6 h, and 24 h after the injections. Patients also graded the overall injection experience as Excellent, Very Good, Fair, Poor, or Awful. The physician evaluated the patients’ eye movement during intravitreal injection on 3 levels: (0) none or minimal, (1) not compromising the injection, and (2) compromising the injection. Results: The patients in Group Drops had the worst mean pain scores during the injection and 10 min after, with the highest occurrence of movements compromising the procedure (Grade 2; 38.7%). The patients in Group SC had a higher percentage of good experiences (37.9%) but a higher incidence of chemosis (16.7%). The patients in Group Gel had similar overall pain scores to Group Drops patients but a higher incidence of keratitis (19.4%). There was no statistically significant correlation between the use of aspirin or anticoagulants and the occurrence of hyperemia or hyposphagma. Conclusion: Subconjunctival lidocaine was most effective in preventing pain and eye movements during intravitreal injections. Although 2% lidocaine gel produced a good overall experience for the patients, the incidence of keratitis was very high (19.4%). Therefore, we do not recommend 2% lidocaine gel as the first anesthetic choice for intravitreal injections. There is no evidence to suspend the use of aspirin or other anticoagulants drugs prior to intravitreal injections. Conselho Brasileiro de Oftalmologia2015-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492015000100008Arquivos Brasileiros de Oftalmologia v.78 n.1 2015reponame:Arquivos brasileiros de oftalmologia (Online)instname:Conselho Brasileiro de Oftalmologia (CBO)instacron:CBO10.5935/0004-2749.20150008info:eu-repo/semantics/openAccessAndrade,Gabriel Costa deCarvalho,André Correa Maia deeng2015-04-16T00:00:00Zoai:scielo:S0004-27492015000100008Revistahttp://aboonline.org.br/https://old.scielo.br/oai/scielo-oai.phpaboonline@cbo.com.br||abo@cbo.com.br1678-29250004-2749opendoar:2015-04-16T00:00Arquivos brasileiros de oftalmologia (Online) - Conselho Brasileiro de Oftalmologia (CBO)false
dc.title.none.fl_str_mv Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial
title Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial
spellingShingle Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial
Andrade,Gabriel Costa de
Efficacy
Anesthesia
Propoxycaine/administration & dosage
Lidocaine/ administration & dosage
Intravitreal injections
Conjunctiva/drug effects
title_short Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial
title_full Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial
title_fullStr Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial
title_full_unstemmed Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial
title_sort Comparison of 3 different anesthetic approaches for intravitreal injections: a prospective randomized trial
author Andrade,Gabriel Costa de
author_facet Andrade,Gabriel Costa de
Carvalho,André Correa Maia de
author_role author
author2 Carvalho,André Correa Maia de
author2_role author
dc.contributor.author.fl_str_mv Andrade,Gabriel Costa de
Carvalho,André Correa Maia de
dc.subject.por.fl_str_mv Efficacy
Anesthesia
Propoxycaine/administration & dosage
Lidocaine/ administration & dosage
Intravitreal injections
Conjunctiva/drug effects
topic Efficacy
Anesthesia
Propoxycaine/administration & dosage
Lidocaine/ administration & dosage
Intravitreal injections
Conjunctiva/drug effects
description Purpose: To compare the anesthetic effectiveness of topical proparacaine drops, subconjunctival lidocaine, and 2% lidocaine gel. Methods: Ninety-two patients undergoing intravitreal injections were randomized to 1 of 3 groups: proparacaine 0.5% drops (Group Drops), proparacaine 0.5% drops plus subconjunctival lidocaine (Group SC), or 2% lidocaine gel (Group Gel). Patients were asked to score their pain experience using a visual analog scale of 0 to 10 immediately following the injections and 10 min, 1 h, 6 h, and 24 h after the injections. Patients also graded the overall injection experience as Excellent, Very Good, Fair, Poor, or Awful. The physician evaluated the patients’ eye movement during intravitreal injection on 3 levels: (0) none or minimal, (1) not compromising the injection, and (2) compromising the injection. Results: The patients in Group Drops had the worst mean pain scores during the injection and 10 min after, with the highest occurrence of movements compromising the procedure (Grade 2; 38.7%). The patients in Group SC had a higher percentage of good experiences (37.9%) but a higher incidence of chemosis (16.7%). The patients in Group Gel had similar overall pain scores to Group Drops patients but a higher incidence of keratitis (19.4%). There was no statistically significant correlation between the use of aspirin or anticoagulants and the occurrence of hyperemia or hyposphagma. Conclusion: Subconjunctival lidocaine was most effective in preventing pain and eye movements during intravitreal injections. Although 2% lidocaine gel produced a good overall experience for the patients, the incidence of keratitis was very high (19.4%). Therefore, we do not recommend 2% lidocaine gel as the first anesthetic choice for intravitreal injections. There is no evidence to suspend the use of aspirin or other anticoagulants drugs prior to intravitreal injections.
publishDate 2015
dc.date.none.fl_str_mv 2015-02-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/0004-2749.20150008
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dc.publisher.none.fl_str_mv Conselho Brasileiro de Oftalmologia
publisher.none.fl_str_mv Conselho Brasileiro de Oftalmologia
dc.source.none.fl_str_mv Arquivos Brasileiros de Oftalmologia v.78 n.1 2015
reponame:Arquivos brasileiros de oftalmologia (Online)
instname:Conselho Brasileiro de Oftalmologia (CBO)
instacron:CBO
instname_str Conselho Brasileiro de Oftalmologia (CBO)
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institution CBO
reponame_str Arquivos brasileiros de oftalmologia (Online)
collection Arquivos brasileiros de oftalmologia (Online)
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