title: Comparison of topical anesthetics for intravitreal injections : a randomized clinical trial.
abstract: OBJECTIVE
  To determine whether there is a difference in anesthetic effect between topical proparacaine drops, 4% lidocaine solution, or 3.5% lidocaine gel, and whether this has an impact on the overall injection experience.
  
  
  METHODS
  One hundred and twenty sequential patients undergoing intravitreal injections were randomized to 1 of 3 groups: proparacaine 0.5% drops (Group 1), proparacaine + 4% lidocaine-soaked cotton tipped swabs (Group 2), or 3.5% lidocaine gel (Group 3). Discomfort associated with the lid speculum, with the needle, and with burning sensation was graded on a scale of 0 to 10 (0 = no pain, 10 = worst pain ever). The overall injection experience was graded as Excellent, Very Good, Fair, Poor, or Awful.
  
  
  RESULTS
  The average lid speculum pain score for Group 1 was 0.85, Group 2 was 0.50, and Group 3 was 0.65 (P = 0.32). The average needle pain score for Group 1 was 1.78, Group 2 was 1.75, and Group 3 was 1.48 (P = 0.38). The average burning pain score for Group 1 was 1.45, Group 2 was 1.58, and Group 3 was 1.13 (P = 0.23). Overall satisfaction was rated as Excellent or Very Good in 95%, 97.5%, and 92.5% of Group 1, 2, and 3 patients, respectively (P = 0.64).
  
  
  CONCLUSIONS
  The use of topical proparacaine drops provides very effective and cost-effective anesthesia during office-based intravitreal injections.
authors.affiliation: Illinois Retina Associates, Joliet, IL, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Davis
authors.forename: John S
authors.initials: JS
authors.lastname: Pollack
authors.forename: Susan
authors.initials: S
authors.lastname: Shott
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000191:economics; D016527:Drug Costs; D005260:Female; D005782:Gels; D006801:Humans; D058449:Intravitreal Injections / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage* / Q000191:economics; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011430:Propoxycaine / Q000008:administration & dosage* / Q000191:economics; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine; C005717:proxymetacaine; D011430:Propoxycaine