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Eur J Ophthalmol. 2007 May-Jun;17(3):332-5.

Is intracameral lidocaine really effective in cataract surgery?

Author information

1
Department of Ophthalmology, Central Hospital of Lahti, Lahti, Finland and Department of Ophthalmology, University of Tampere, Tampere, Finland. juha.valimaki@phks.fi

Abstract

PURPOSE:

To evaluate the usefulness of intracameral lidocaine in cataract surgery under topical anesthesia and especially if the patient wanted intravenous sedation preoperatively.

METHODS:

In this prospective study 96 patients were randomly assigned to receive 0.5 cc of balanced salt solution (Group 1) or 1% unpreserved lidocaine (Group 2). Patients who wanted sedation received intravenous midazolam hydrochloride. All surgery was done by one surgeon using a clear corneal technique.

RESULTS:

Mean pain scores were 0.73 (of a maximum 3) in Group 1 and 0.54 in Group 2; the difference between groups was not statistically significant. Forty patients in Group 1 (83%) and 44 patients in Group 2 (92%) reported no discomfort or only mild discomfort. The two study groups were comparable in need for intravenous midazolam. Logistic regression analysis showed a significant relationship between pain scores and intravenous sedation (p=0.02) but not with intracameral lidocaine or other tested variables. However, odds ratio for pain increased to 5.1 (95% CI; 1.29-20.41) in participants without intravenous sedation compared to those with sedation.

CONCLUSIONS:

The results of the present study suggest that intravenous sedation preoperatively seems to be an important determinant to relieve the sensation of discomfort/pain during small incision cataract surgery, but intracameral lidocaine was shown not to have a clinically useful role.

PMID:
17534812
[Indexed for MEDLINE]

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