Unpreserved lidocaine to control discomfort during cataract surgery using topical anesthesia.
OBJECTIVE
To determine whether intraoperative unpreserved lidocaine further decrease discomfort or pain during sutureless small incision cataract surgery and intraocular lens (IOL) implantation under topical anesthesia.


METHODS
Outpatient ambulatory surgical center.


METHODS
In this prospective controlled study, comparable eligible patients were randomized to receive 0.1 cc unpreserved lidocaine 1% or 0.1 cc balanced salt solution (BSS) (control group) in double-masked fashion. Study drugs were injected intracamerally 1 minute before phacoemulsification. A predefined uniform pain/discomfort scale was used for assessment during phacoemulsification and IOL insertion. A secondary study using a 0.5 cc dose was also performed.


RESULTS
Twenty-six percent in the control group and 9% in the lidocaine group had discomfort pain scores of 2 or more; 10% in the BSS group felt increased pressure or pain during phacoemulsification. In the lidocaine group, discomfort was felt mainly during IOL insertion, possibly as a result of wound manipulation. During phacoemulsification, no patient in the lidocaine group reported pain; 2% felt increased pressure during phacoemulsification. A dose increase to 0.5 cc reduced any intraocular sensation to 3% in the lidocaine group. No patient in either group had significant cell loss or adverse events.


CONCLUSIONS
Intraoperative lidocaine is safe and effective in controlling intraoperative discomfort.
Gills
J P
JP
St. Luke's Cataract and Laser Institute, Tarpon Springs, Florida 34688-5000, USA.
Cherchio
M
M
Raanan
M G
MG
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002387:Cataract Extraction; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D018918:Phacoemulsification; D011446:Prospective Studies
D000779:Anesthetics, Local; D008012:Lidocaine