title: Proparacaine hydrochloride topical drop and intracameral 0.5% lignocaine for phacotrabeculectomy in patients with primary open angle glaucoma.
abstract: OBJECTIVE
  To compare the efficacy and safety of 0.5% intracameral lignocaine to 1% intracameral lignocaine prior to phacotrabeculectomy.
  
  
  METHODS
  Prospective, comparative, observational, and interventional study.
  
  
  METHODS
  Tertiary eye care center in central India.
  
  
  METHODS
  This study was comprised of 79 patients (79 eyes) with primary open angle glaucoma scheduled for phacotrabeculectomy. Patients were assigned to 1 of 2 Groups receiving proparacaine 0.5% eye drops and 1% intracameral lignocaine just prior to phacotrabeculectomy (Group 1, n = 39) and 0.5% intracameral lignocaine after completion of phacoemulsification just prior to trabeculectomy (Group 2, n = 40). The visual analogue scale was used to record intraoperative and postoperative pain. Patient comfort, intraoperative painful sensations perceived by the patient, supplemental anesthesia, complications, and surgeon discomfort were noted. An anesthetist also noted the vital parameters and the requirement for intravenous medications.
  
  
  RESULTS
  There was no significant difference in the intraoperative pain score (P = 0.0733) or supplemental anesthesia (P = 0.372) between Groups. Postoperative pain score was statistically significant in Group 2 (P < 0.0001). The overall operating conditions in both Groups were comparable (P = 0.7389). A greater number of patients in Group 2 (88.57%) preferred the same anesthetic technique for combined surgery in the fellow eye. There was no difference in inadvertent eye movements and lid squeezing between Groups and they did not interfere with surgery.
  
  
  CONCLUSIONS
  Topical anesthetic drops supplemented with 0.5% intracameral lignocaine before performing trabeculectomy is as effective as 1% intracameral lignocaine given at the beginning of phacotrabeculectomy for primary open angle glaucoma.
authors.affiliation: Department of Ophthalmology, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, India.
authors.forename: Rajesh Subhash
authors.initials: RS
authors.lastname: Joshi
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000867:Anterior Chamber / Q000187:drug effects; D058447:Eye Pain; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D056965:Injections, Intraocular; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain; D018918:Phacoemulsification / Q000379:methods*; D011430:Propoxycaine / Q000008:administration & dosage*; D011446:Prospective Studies; D014130:Trabeculectomy / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; C005717:proxymetacaine; D011430:Propoxycaine
keywords: Intracameral Lignocaine; Phacotrabeculectomy; Topical Anesthesia; Visual Analog scale
references.citation: Indian J Ophthalmol. 2002 Sep;50(3):197-200
references.pmid: 12355693
references.citation: J Cataract Refract Surg. 1999 May;25(5):606-7
references.pmid: 10330629
references.citation: J Cataract Refract Surg. 2001 Aug;27(8):1207-13
references.pmid: 11524191
references.citation: J Glaucoma. 2002 Jun;11(3):271-4
references.pmid: 12140406
references.citation: J Cataract Refract Surg. 2001 Aug;27(8):1214-20
references.pmid: 11524192
references.citation: Br J Ophthalmol. 1992 Nov;76(11):670-4
references.pmid: 1477043
references.citation: Br J Ophthalmol. 2004 Aug;88(8):1004-7
references.pmid: 15258014
references.citation: J Cataract Refract Surg. 1995 Nov;21(6):666-71
references.pmid: 8551444
references.citation: Retina. 2000;20(1):41-5
references.pmid: 10696746
references.citation: Middle East Afr J Ophthalmol. 2013 Jul-Sep;20(3):221-4
references.pmid: 24014985
references.citation: J Cataract Refract Surg. 1996 Jun;22(5):612-4
references.pmid: 8784636
references.citation: Ophthalmology. 1996 Aug;103(8):1196-203
references.pmid: 8764787
references.citation: Ophthalmic Surg Lasers. 1999 Mar;30(3):205-7
references.pmid: 10100254
references.citation: Eye (Lond). 1993;7 ( Pt 3):457-60
references.pmid: 8224307
references.citation: J Fr Ophtalmol. 2003 May;26(5):521-4
references.pmid: 12819615