title: Lidocaine gel anesthesia for intravitreal drug administration.
abstract: OBJECTIVE
  To describe the use of topical gel anesthesia for intravitreal injection drug delivery.
  
  
  METHODS
  The first group (n=12) of patients is a crossover group of patients who on separate occasions received intravitreal injections after both 2% lidocaine subconjunctival injection (SC) and 2% lidocaine topical gel anesthesia using 30-gauge needle. The second group (n=16) is a consecutive group of patients who received either SC (n=8) or gel (n=8) anesthesia before intravitreal injection of triamcinolone using 27.5-gauge needle. Descriptive and numerical pain analog scale was used to assess pain sensation.
  
  
  RESULTS
  : There was no difference in pain score between gel and SC within the first group (P=0.67, paired, nonparametric test) and no difference in pain score comparing patients who had either SC or gel anesthesia before 27.5-gauge intravitreal injections (P=0.82, unpaired t-test) in the second group. However, there were significant differences in incidence of chemosis (P<0.001) and subconjunctival hemorrhage (P<0.001) after injection versus gel anesthesia in both groups.
  
  
  CONCLUSIONS
  Anesthesia with lidocaine 2% gel provides satisfactory patient comfort for administration of intravitreal injection and causes less chemosis and hemorrhage than SC anesthesia.
authors.affiliation: University of California San Diego, Jacobs Retina Center, Shiley Eye Center, La Jolla, California 92037, USA.
authors.forename: Igor
authors.initials: I
authors.lastname: Kozak
authors.forename: Lingyun
authors.initials: L
authors.lastname: Cheng
authors.forename: William R
authors.initials: WR
authors.lastname: Freeman
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D003228:Conjunctiva; D018592:Cross-Over Studies; D005260:Female; D005782:Gels; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007267:Injections / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D014822:Vitreous Body
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D005938:Glucocorticoids; D008012:Lidocaine; D014222:Triamcinolone Acetonide