title: Povidone-iodine before lidocaine gel anesthesia achieves surface antisepsis.
abstract: OBJECTIVE
  Viscous lidocaine interferes with ocular surface antisepsis. The current study was designed to evaluate the impact on surface antisepsis of different application sequences with lidocaine gel and povidone-iodine solution.
  
  
  METHODS
  Blood agar plates inoculated with Staphylococcus epidermidis were treated with varying sequences of 2% lidocaine gel and 5% povidone-iodine solution. The plates were then incubated at 37°C for 24 hours and bacterial growth was determined.
  
  
  RESULTS
  Plates on which povidone-iodine was applied alone or prior to lidocaine gel demonstrated no bacterial growth regardless of whether the antiseptic was retained on the plate for 5 seconds or for 30 seconds. There was no statistically significant difference between bacterial growth on plates not treated with povidone-iodine and on plates treated with lidocaine gel alone or prior to povidone-iodine (P = .553 and P = .485, respectively).
  
  
  CONCLUSIONS
  Povidone-iodine effectively reduces bacterial counts when applied alone or prior to lidocaine gel. Lidocaine gel was confirmed to be a barrier to antisepsis when administered prior to povidone-iodine.
authors.affiliation: Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA 94115, USA.
authors.forename: Rishi R
authors.initials: RR
authors.lastname: Doshi
authors.forename: Theodore
authors.initials: T
authors.lastname: Leng
authors.forename: Anne E
authors.initials: AE
authors.lastname: Fung
mesh_terms: D000779:Anesthetics, Local / Q000494:pharmacology*; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D000985:Antisepsis / Q000379:methods*; D015169:Colony Count, Microbial; D005782:Gels; D008012:Lidocaine / Q000494:pharmacology*; D011206:Povidone-Iodine / Q000494:pharmacology*; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000254:growth & development
chemical_list: D000779:Anesthetics, Local; D000891:Anti-Infective Agents, Local; D005782:Gels; D011206:Povidone-Iodine; D008012:Lidocaine