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Journal of the American Veterinary... Nov 2018OBJECTIVE To evaluate the effects of topical ophthalmic application of 0.5% proparacaine hydrochloride solution (PHCL; containing 0.01% benzalkonium chloride as...
OBJECTIVE To evaluate the effects of topical ophthalmic application of 0.5% proparacaine hydrochloride solution (PHCL; containing 0.01% benzalkonium chloride as preservative) on aerobic bacterial culture results for naturally occurring infected corneal ulcers in dogs. DESIGN Clinical trial. ANIMALS 25 client-owned dogs with infected corneal ulcers (24 unilaterally affected and 1 bilaterally affected; only 1 eye included/dog) examined between June 2008 and May 2011. PROCEDURES Swab samples for aerobic bacterial culture were collected from the periphery of each corneal ulcer before and approximately 1 minute after topical ophthalmic application of 1 drop of PHCL. Numbers of aerobic bacterial species isolated from affected eyes were compared between sample collection points and between other variables (ie, side [left or right] of affected eye, prior treatments, and patient age, sex, and neuter status). RESULTS There was no significant difference between numbers of aerobic bacterial species isolated per eye or overall aerobic bacterial culture results (positive or negative) before versus after PHCL application. Similarly, prior treatment had no significant effect on aerobic bacterial culture results for samples collected at either point. The most commonly isolated bacteria before and after PHCL application were Staphylococcus spp (40% and 48%, respectively), followed by Streptococcus spp (23% and 22%, respectively). CONCLUSIONS AND CLINICAL RELEVANCE Topical ophthalmic application of PHCL did not significantly affect aerobic bacterial culture results for naturally occurring infected corneal ulcers in dogs as assessed in this study. Therefore, topical ophthalmic PHCL application could be useful in clinical settings prior to sample collection to relieve patient discomfort and to aid in sample acquisition without compromising aerobic bacterial culture results.
Topics: Administration, Topical; Anesthetics, Local; Animals; Bacterial Infections; Corneal Ulcer; Dog Diseases; Dogs; Female; Male; Ophthalmic Solutions; Propoxycaine
PubMed: 30311533
DOI: 10.2460/javma.253.9.1140 -
International Ophthalmology Jul 2019To measure IOP in animals, it is often necessary to use topical anesthetics. The use of these drugs may cause changes in IOP and interfere with the final results. To...
PURPOSE
To measure IOP in animals, it is often necessary to use topical anesthetics. The use of these drugs may cause changes in IOP and interfere with the final results. To address this issue, the effects of four local anesthetics (tetracaine, proparacaine, lidocaine, and bupivacaine) on IOP were investigated in ten adult dogs.
METHODS
One drop of tetracaine was instilled in the right eye of half of the dogs and in the left eye of the other dogs; normal saline was instilled in the fellow eyes. The IOP in each dog was measured before and at 0, 5, 10, 15, 20, 25, 30, and 35 min after drug instillation using an electronic rebound tonometer. The effects of the other anesthetics were studied in the same way at intervals of at least 1 week.
RESULTS
After instillation of tetracaine, the IOP decreased gradually, such that after 15 min, the IOP was significantly lower than the baseline (p = 0.022) and control values (p = 0.048). Proparacaine also reduced IOP after 10 min compared to baseline values (p = 0.046), but the two other drugs, bupivacaine and lidocaine, had no significant effect on IOP. The duration of eye anesthesia was 16, 20, 22, and 34 min for tetracaine, lidocaine, bupivacaine, and proparacaine, respectively.
CONCLUSION
We recommend using drugs that combine inducing longer anesthesia with producing the smallest change in IOP, such as bupivacaine and, subsequently, lidocaine. Tetracaine and proparacaine have a significant effect on IOP, and if these drugs are used, this effect should be considered.
Topics: Administration, Topical; Anesthesia, Local; Anesthetics, Local; Animals; Bupivacaine; Disease Models, Animal; Dogs; Female; Glaucoma; Intraocular Pressure; Lidocaine; Male; Propoxycaine; Tetracaine
PubMed: 29934932
DOI: 10.1007/s10792-018-0969-0 -
Journal of Tropical Pediatrics Apr 2015To assess the effectiveness of expressed breast milk (EBM) on neonatal pain during screening for retinopathy of prematurity (ROP). (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To assess the effectiveness of expressed breast milk (EBM) on neonatal pain during screening for retinopathy of prematurity (ROP).
METHODS
Neonates who were on oral feeds undergoing ROP screening were included. Babies were randomized into intervention group (EBM + Standard practice) and control group. The standard practice is proparacaine, nesting and swaddling. Pain was assessed by PIPP scale, during and at 1 and 5 min after the procedure by the principal investigator who was blinded.
RESULTS
The groups were similar in baseline characteristics. The group receiving EBM had significantly lower PIPP scores during the procedure 12.7 ± 1.69 compared to the control group 15.5 ± 1.78 (p < 0.05). The beneficial effect persisted at 1 min and 5 min after the procedure 6.20 ± 1.9 vs. 12.4 ± 2.54 (p ≤ 0.05) at 1 min; 3.2 ± 1.5 and 6.85 ± 2.4 (p < 0.05) at 5 min.
CONCLUSION
Oral EBM significantly reduces pain during and after ROP screening.
Topics: Anesthetics, Local; Breast Feeding; Double-Blind Method; Female; Humans; Infant, Newborn; Male; Mass Screening; Milk, Human; Outcome Assessment, Health Care; Pain; Pain Measurement; Propoxycaine; Retinopathy of Prematurity; Vision Screening
PubMed: 25541552
DOI: 10.1093/tropej/fmu073 -
Regional Anesthesia and Pain Medicine 2016The aim of this experiment was to investigate the interaction between epinephrine and 2 local anesthetics (proxymetacaine or oxybuprocaine) using subcutaneous injections...
BACKGROUND
The aim of this experiment was to investigate the interaction between epinephrine and 2 local anesthetics (proxymetacaine or oxybuprocaine) using subcutaneous injections under the hairy skin, thereby simulating infiltration blocks.
METHODS
Using a rat model of cutaneous trunci muscle reflex in response to local skin pinpricks, the anesthetic properties of proxymetacaine and oxybuprocaine alone and in combination with epinephrine as an infiltrative anesthetic were tested. Isobolographic analysis was used for the analgesic interactions between adjuvant epinephrine and the local anesthetics. Lidocaine was used as a control group.
RESULTS
Oxybuprocaine, proxymetacaine, and lidocaine elicited a dose-dependent block to pinpricks. On the 50% effective dose (ED50) basis, their relative potencies were proxymetacaine [0.126 (0.113-0.141) μmol] greater than oxybuprocaine [0.208 (0.192-0.226) μmol] greater than lidocaine [6.331 (5.662-7.079) μmol] (P < 0.01 for each comparison). On an equipotent basis (ED25, ED50, and ED75), sensory block duration elicited by oxybuprocaine or proxymetacaine was greater than that elicited by lidocaine (P < 0.01). Coadministration of proxymetacaine, oxybuprocaine, or lidocaine with epinephrine produced a synergistic analgesic effect and prolonged the cutaneous analgesic effect. After adding epinephrine, oxybuprocaine was much faster, reaching its maximal blockade, than proxymetacaine or lidocaine (P < 0.01).
CONCLUSIONS
We concluded that proxymetacaine and oxybuprocaine were more potent and produced greater duration of nociceptive block than lidocaine. The use of epinephrine augmented the potency and prolonged the duration of proxymetacaine, oxybuprocaine, and lidocaine as an infiltrative anesthetic.
Topics: Adrenergic Agonists; Analgesia; Anesthetics, Local; Animals; Behavior, Animal; Dose-Response Relationship, Drug; Drug Combinations; Drug Synergism; Epinephrine; Injections, Subcutaneous; Lidocaine; Male; Models, Animal; Pain Threshold; Procaine; Propoxycaine; Rats, Sprague-Dawley; Skin; Time Factors
PubMed: 27483414
DOI: 10.1097/AAP.0000000000000446 -
Retina (Philadelphia, Pa.) Jun 2021Lidocaine gel was suggested to be highly effective in providing anesthesia for intravitreal injections but adverse effects include a possibility of making sterilization... (Comparative Study)
Comparative Study
PURPOSE
Lidocaine gel was suggested to be highly effective in providing anesthesia for intravitreal injections but adverse effects include a possibility of making sterilization of the conjunctiva difficult. Hence, we wished to determine the effect of using 0.5% proparacaine drops alone over the use of 3.5% lidocaine hydrochloride gel anesthesia during office-based intravitreal injections.
METHODOLOGY
This was a case-control study in patients who came routinely to the clinic for antivascular endothelial growth factor injections. Eyes were treated with one of two anesthesia modalities. A total of 216 injections in 120 patients were reviewed. One group (N = 107) underwent anesthesia with 0.5% proparacaine drops, and the control group (N = 109) received 3.5% lidocaine gel. The pain perceived after injection was graded using the numerical rating scale, and score was immediately recorded by the "masked" injecting physician.
RESULTS
The mean pain score (±SD) for the proparacaine-only group versus gel group was 1.97 (±1.17) versus 1.76 (±0.92), P value = 0.3174. There was no statistical difference between the 2 groups.
CONCLUSION
3.5% lidocaine gel is not superior to 0.5% proparacaine drops as patients attained good pain control and excellent rates of overall satisfaction with proparacaine drops alone.
Topics: Aged; Aged, 80 and over; Anesthesia, Local; Anesthetics, Local; Case-Control Studies; Drug Substitution; Female; Humans; Intravitreal Injections; Lidocaine; Male; Middle Aged; Ophthalmic Solutions; Propoxycaine; Prospective Studies
PubMed: 33141787
DOI: 10.1097/IAE.0000000000003013 -
Analytical Sciences : the International... 2018Proparacaine, one of the most common local anesthetics to facilitate diagnosis and treatment of eye diseases, was assayed by square wave voltammetry using a paste...
Proparacaine, one of the most common local anesthetics to facilitate diagnosis and treatment of eye diseases, was assayed by square wave voltammetry using a paste electrode prepared with carbon nanotubes. In cyclic voltammetric studies, proparacaine has exhibited a single irreversible anodic peak at around + 900 mV vs. Ag/AgCl in pH 6.0 Britton-Robinson buffer solution. It was suggested that the peak had appeared due to the oxidation of the NH group on the proparacaine molecule. Prior to the determination of the proparacaine by square wave stripping voltammetry (SWSV) on the fabricated multi-walled carbon nanotube paste electrode (MWCNTPE), the accumulation potential (E), accumulation time (t), pulse amplitude (ΔE), step potential (ΔE) and frequency (f ) parameters were optimized. The peak currents plotted in the range of 0.5 - 12.5 mg/L proparacaine exhibited two linear sections with a detection limit of 0.11 mg/L. The results for the determination of proparacaine on a pharmaceutical local anesthetic (Alcaine) showed that relative standard deviation (RSD) and relative error (RE) were 4.1 and -2.0%, respectively. Selectivity has also been investigated and results showed recoveries of 5.0 mg/L proparacaine in the presence of 5.0 mg/L dopamine, ascorbic acid and uric acid as 106.9 ± 0.8, 99.9 ± 1.2 and 94.1 ± 0.7, respectively.
Topics: Administration, Ophthalmic; Electrochemical Techniques; Electrodes; Nanotubes, Carbon; Propoxycaine
PubMed: 29998957
DOI: 10.2116/analsci.17P589 -
Eye & Contact Lens Jun 2024Corneal abrasions are among the most common ophthalmic injuries in the emergency department (ED) and primarily present as severe ocular pain. Topical anesthetics provide...
Corneal abrasions are among the most common ophthalmic injuries in the emergency department (ED) and primarily present as severe ocular pain. Topical anesthetics provide temporary analgesia, but overuse is associated with complications including further corneal injury, infection, and vision loss. This case series describes three patients who used a 15-mL bottle of 0.05% proparacaine hydrochloride ophthalmic solution after discharge from the ED and returned within three days with corneal injury and pain. Although the use of topical anesthetics is traditionally discouraged by ophthalmologists, publications in the emergency medicine literature support their use. We review the literature surrounding topical anesthetic use in the ED setting and caution against prescribing patients topical anesthetics for corneal abrasions, particularly without patient counseling and significant restriction of anesthetic supply.
Topics: Humans; Propoxycaine; Emergency Service, Hospital; Anesthetics, Local; Corneal Injuries; Male; Female; Eye Pain; Adult; Middle Aged; Ophthalmic Solutions
PubMed: 38477795
DOI: 10.1097/ICL.0000000000001083 -
Middle East African Journal of... 2014To compare the efficacy and safety of 0.5% intracameral lignocaine to 1% intracameral lignocaine prior to phacotrabeculectomy. (Comparative Study)
Comparative Study Observational Study
AIM
To compare the efficacy and safety of 0.5% intracameral lignocaine to 1% intracameral lignocaine prior to phacotrabeculectomy.
STUDY DESIGN
Prospective, comparative, observational, and interventional study.
SETTING
Tertiary eye care center in central India.
MATERIALS AND 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.
CONCLUSION
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.
Topics: Adult; Anesthesia, Local; Anesthetics, Local; Anterior Chamber; Eye Pain; Female; Glaucoma, Open-Angle; Humans; Injections, Intraocular; Lidocaine; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Phacoemulsification; Propoxycaine; Prospective Studies; Trabeculectomy
PubMed: 25100903
DOI: 10.4103/0974-9233.134669 -
Arquivos Brasileiros de Oftalmologia 2015To compare the anesthetic effectiveness of topical proparacaine drops, subconjunctival lidocaine, and 2% lidocaine gel. (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To compare the anesthetic effectiveness of topical proparacaine drops, subconjunctival lidocaine, and 2% lidocaine gel.
METHODS
Ninety-two patients undergoing intravitreal injections were randomized to 1 of 3 groups: proparacaine 0.5% drops (Group Drops), proparacaine 0.5% drops plus subconjunctival lidocaine (Group SC), or 2% lidocaine gel (Group Gel). Patients were asked to score their pain experience using a visual analog scale of 0 to 10 immediately following the injections and 10 min, 1 h, 6 h, and 24 h after the injections. Patients also graded the overall injection experience as Excellent, Very Good, Fair, Poor, or Awful. The physician evaluated the patients' eye movement during intravitreal injection on 3 levels: (0) none or minimal, (1) not compromising the injection, and (2) compromising the injection.
RESULTS
The patients in Group Drops had the worst mean pain scores during the injection and 10 min after, with the highest occurrence of movements compromising the procedure (Grade 2; 38.7%). The patients in Group SC had a higher percentage of good experiences (37.9%) but a higher incidence of chemosis (16.7%). The patients in Group Gel had similar overall pain scores to Group Drops patients but a higher incidence of keratitis (19.4%). There was no statistically significant correlation between the use of aspirin or anticoagulants and the occurrence of hyperemia or hyposphagma.
CONCLUSION
Subconjunctival lidocaine was most effective in preventing pain and eye movements during intravitreal injections. Although 2% lidocaine gel produced a good overall experience for the patients, the incidence of keratitis was very high (19.4%). Therefore, we do not recommend 2% lidocaine gel as the first anesthetic choice for intravitreal injections. There is no evidence to suspend the use of aspirin or other anticoagulants drugs prior to intravitreal injections.
Topics: Adult; Aged; Aged, 80 and over; Anesthesia, Local; Anesthetics, Local; Eye Movements; Female; Humans; Intravitreal Injections; Keratitis; Lidocaine; Macular Degeneration; Macular Edema; Male; Middle Aged; Pain Measurement; Patient Satisfaction; Propoxycaine; Prospective Studies
PubMed: 25714534
DOI: 10.5935/0004-2749.20150008 -
Cornea Oct 2020
Topics: Adolescent; Adult; Anesthetics, Local; Female; Humans; Lacrimal Apparatus; Male; Propoxycaine; Tears; Young Adult
PubMed: 32618855
DOI: 10.1097/ICO.0000000000002410