Literature DB >> 20570360

Subconjunctival lidocaine before laser treatment: a randomized trial.

Paul E Tesha1, Louis R Giavedoni, Alan R Berger, Filiberto Altomare, David R Chow, Eduardo V Navajas, Pradeepa Yoganathan, David T Wong, Andre Principe.   

Abstract

PURPOSE: The aim of the study was to determine whether subconjunctival anesthesia is effective at reducing pain associated with laser retinopexy.
DESIGN: This was a single-center, prospective, patient-masked, randomized, controlled trial. PARTICIPANTS: In the primary study group, 65 patients were recruited. Thirty-two patients (32 eyes) received anesthetic injection, and 33 patients (33 eyes) received the sham injection. The crossover study group consisted of 28 patients (56 eyes).
METHODS: Between February 2008 and April 2008, all patients who were consecutively booked to undergo panretinal photocoagulation (PRP) or peripheral laser retinopexy (PLR) were invited to participate in the study. Patients were randomized to receive subconjunctival lidocaine injection or a sham injection before their intended laser retinal treatment. These patients were defined as our primary study group. Patients who required a second laser treatment received the opposite injection in a masked fashion before laser retinal treatment. These patients were defined as our crossover group. Patients in both the primary study group and the crossover group were masked to the treatment given. After the laser treatment, patients completed a pain questionnaire. MAIN OUTCOME MEASURES: The primary outcome was incidence of pain. The secondary outcome was severity of pain.
RESULTS: Primary study group: In the anesthetic treatment group, 19 patients (59%) experienced pain compared with 32 patients (97%) in the sham treatment group (P<0.001). Among the patients who did experience pain, the average pain score was 3.6 in the anesthetic treatment group and 4.1 in the sham treatment group (P=0.55). Crossover study group: In the anesthetic treatment group, 12 patients (43%) experienced pain compared with 28 patients (100%) in the sham treatment group (P<0.001). In patients who did experience pain, the average pain score was 3.3 in the anesthetic treatment group and 4.6 in the sham treatment group. Twenty patients (71%) preferred anesthetic to sham treatments, 1 patient (4%) preferred sham over anesthetic, and 7 patients (25%) thought both laser treatments were the same.
CONCLUSIONS: Subconjunctival 2% lidocaine significantly reduces the incidence of pain in patients who receive PRP or PLR.
Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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Year:  2010        PMID: 20570360     DOI: 10.1016/j.ophtha.2010.01.036

Source DB:  PubMed          Journal:  Ophthalmology        ISSN: 0161-6420            Impact factor:   12.079


  4 in total

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Journal:  Graefes Arch Clin Exp Ophthalmol       Date:  2012-10-11       Impact factor: 3.117

2.  Transnasal sphenopalatine ganglion block for pain relief during panretinal photocoagulation laser for diabetic retinopathy: a pre and post interventional study.

Authors:  Mehdi Sanatkar; Fatemeh Bazvand
Journal:  Sci Rep       Date:  2022-06-29       Impact factor: 4.996

3.  Diabetic retinopathy treated with laser photocoagulation and the indirect effect on glycaemic control.

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Journal:  J Diabetes Res       Date:  2014-07-17       Impact factor: 4.011

4.  Metamizole versus placebo for panretinal photocoagulation pain control: a prospective double-masked randomized controlled study.

Authors:  Rafael Barbosa de Araújo; Leandro Cabral Zacharias; Breno Marques de Azevedo; Beatrice Schmidt Giusti; Rony Carlos Pretti; Walter Y Takahashi; Mário Luiz Ribeiro Monteiro
Journal:  Int J Retina Vitreous       Date:  2015-11-12
  4 in total

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