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Middle East African Journal of... 2013The purpose of this study was to compare the efficacy of a single drop of 0.5% proparacaine hydrochloride in uncomplicated cataract surgery with phacoemulsification. (Comparative Study)
Comparative Study Randomized Controlled Trial
PURPOSE
The purpose of this study was to compare the efficacy of a single drop of 0.5% proparacaine hydrochloride in uncomplicated cataract surgery with phacoemulsification.
MATERIALS AND METHODS
Two hundred and ninety five patients scheduled for the phacoemulsification were divided into 2 groups based on the anesthetic agents they were to receive: 146 patients who received a single drop of 0.5% proparacaine 2 min before the start of the surgery (proparacaine group) and; 149 patients who received supplementation of 0.5% intracameral preservative free xylocaine (xylocaine group). A single surgeon performed all surgeries. Intraoperative and post-operative pain scores were evaluated on a visual analog scale. The surgeon noted his subjective impression of corneal clarity, discomfort while performing the surgery any supplemental anesthesia required and intraoperative complications. An anesthetist noted vital parameters and the need for intravenous sedation. Total surgical time was noted. Comparison of parameters was performed with the Chi-square test, and A P value less than 0.05 was considered as statistically significant.
RESULTS
No statistically significant difference was seen in the intraoperative (P = 0.24) and post-operative (P = 0.164) pain scores between groups. There was no pain (0 score) in 41.8% of patients in the proparacaine group and 46.3% of patients in the xylocaine group. The average surgical time (P = 0.279) and surgeon discomfort (P = 0.07) were not statistically significantly different between groups. No patients required supplemental anesthesia. There were no surgical complications that could compromise the visual outcome. An equal number of patients in both groups preferred same type of anesthetic technique for the fellow eye cataract surgery (89.11% for the proparacaine group and 90.18% for the xylocaine group). No patients in either group had changes in vital parameters or required intravenous sedation.
CONCLUSION
A single drop pre-operatively, of proparacaine hydrochloride was comparable to the intracameral supplementation of preservative free xylocaine for phacoemulsification in uncomplicated cataract surgery without compromising the visual outcome. However, we recommend individualizing the anesthetic technique according to the requirements of the surgeon.
Topics: Adult; Aged; Anesthesia, Local; Anesthetics, Combined; Anesthetics, Local; Female; Humans; Lens Implantation, Intraocular; Lidocaine; Male; Middle Aged; Ophthalmic Solutions; Pain Measurement; Phacoemulsification; Propoxycaine; Prospective Studies; Visual Acuity
PubMed: 24014985
DOI: 10.4103/0974-9233.114795 -
American Journal of Veterinary Research Nov 2000To evaluate, for clinically normal dogs, results of Schirmer tear tests in eyes without topical anesthetic (STT) and to detect differences associated with breed, sex,...
OBJECTIVE
To evaluate, for clinically normal dogs, results of Schirmer tear tests in eyes without topical anesthetic (STT) and to detect differences associated with breed, sex, age, day, and time of day in eyes in which STT was performed after use of topical anesthetic (STTa).
ANIMALS
41 Beagles, 43 Labrador Retrievers, 25 Golden Retrievers, 26 English Springer Spaniels, and 22 Shetland Sheepdogs.
PROCEDURE
Beagles had STT and STTa values measured twice daily for 5 days. Client-owned dogs of 4 other breeds had STT and STTa values measured once.
RESULTS
Mean +/- SD values of Beagles for STT and STTa were 20.2 +/- 2.5 and 3.8 +/- 2.7 mm/min. Mean values for STT and STTa were as follows: Labrador Retriever, 22.9 +/- 4.1 and 9.6 +/- 3.8 mm/min; English Springer Spaniel; 20.7 +/- 3.2 and 5.4 +/- 3.4 mm/min; Golden Retriever, 21.8 + 3.7 and 8.8 +/- 3.1 mm/min; and Shetland Sheepdog, 15.8 +/- 1.8 and 3.6 +/- 2.8 mm/min. Overall mean values for STT and STTa were 20.2 +/- 3.0 and 6.2 +/- 3.1 mm/min. Differences for STT and STTa were detected among breeds, but significant differences were not associated with sex or age within each breed or in overall values for all dogs.
CONCLUSIONS AND CLINICAL RELEVANCE
Results for the STT reported here compare favorably with reported values, except for results of Shetland Sheepdogs; however, results for the STTa differ dramatically from reported values. Clinicians should consider effects attributable to breed when evaluating results of STT and STTa in dogs.
Topics: Administration, Topical; Age Factors; Anesthesia, Local; Anesthetics, Local; Animals; Circadian Rhythm; Dog Diseases; Dogs; Female; Keratoconjunctivitis Sicca; Male; Propoxycaine; Reference Values; Sex Factors; Tears
PubMed: 11108191
DOI: 10.2460/ajvr.2000.61.1422 -
Investigative Ophthalmology & Visual... Jun 2009To determine the effect of proparacaine-induced topical anesthesia on episcleral venous pressure (EVP).
PURPOSE
To determine the effect of proparacaine-induced topical anesthesia on episcleral venous pressure (EVP).
METHODS
In anesthetized rabbits (n = 11), EVP was measured with a servonull micropressure system, with glass pipettes with 2- to 3-microm tips used to cannulate episcleral veins. Additional measurements included arterial, intraocular, and orbital venous pressures obtained by direct cannulation, to assess the ocular pressure gradients, and carotid blood flow and heart rate, to verify preparation stability. The protocol entailed 5 to 10 minutes of stable baseline recording followed by topical application of proparacaine (0.5%, 10 microL) with continued measurements for another 5 to 15 minutes.
RESULTS
Baseline EVP without topical anesthesia was 12.3 +/- 1.1 mm Hg. EVP decreased significantly to 8.7 +/- 0.9 mm Hg within minutes after application of proparacaine. A small decrease also occurred in intraocular pressure. All other measured variables were unchanged.
CONCLUSIONS
These results suggest that the episcleral circulation is under tonic neural control and that either an upstream resistance site is under tonic vasodilatory control or a downstream site is under vasoconstrictor control.
Topics: Administration, Topical; Anesthesia, Local; Anesthetics, Local; Animals; Female; Heart Rate; Intraocular Pressure; Male; Propoxycaine; Rabbits; Regional Blood Flow; Sclera; Transducers, Pressure; Venous Pressure
PubMed: 19151377
DOI: 10.1167/iovs.08-3048 -
The British Journal of Ophthalmology Apr 2001To evaluate the relative merits of proxymetacaine-fluorescein (PROX-FLU) and lignocaine-fluorescein (LIG-FLU) when used to perform applanation tonometry. (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
AIMS
To evaluate the relative merits of proxymetacaine-fluorescein (PROX-FLU) and lignocaine-fluorescein (LIG-FLU) when used to perform applanation tonometry.
METHODS
This prospective, masked, double blind study assessed several aspects of the tonometry process-the duration of the stinging sensation and degree of discomfort, the extent of reflex lacrimation induced, the need for subsequent tear film manipulation to ensure an accurate tonometry reading, and total time to complete tonometry-for each preparation.
RESULTS
PROX-FLU caused significantly less discomfort and reflex lacrimation than LIG-FLU and accurate tonometry was more rapidly completed when it was used. PROX-FLU was preferred by 98% of the study patients.
CONCLUSION
PROX-FLU is a well tolerated and useful alternative to the more widely used LIG-FLU mixture.
Topics: Adult; Aged; Aged, 80 and over; Anesthetics, Local; Coloring Agents; Double-Blind Method; Female; Fluorescein; Humans; Lidocaine; Male; Middle Aged; Pain; Patient Satisfaction; Propoxycaine; Prospective Studies; Tears; Time Factors; Tonometry, Ocular
PubMed: 11264141
DOI: 10.1136/bjo.85.4.477 -
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 -
Anaesthesia Jul 2013We conducted a randomised trial comparing lidocaine 2% gel with proparacaine 0.5% eye drops in children having elective squint surgery. One hundred and forty children... (Comparative Study)
Comparative Study Randomized Controlled Trial
We conducted a randomised trial comparing lidocaine 2% gel with proparacaine 0.5% eye drops in children having elective squint surgery. One hundred and forty children aged between 3 and 14 years were recruited. The requirement for intra-operative fentanyl and postoperative ibuprofen was significantly less in the lidocaine group compared with the proparacaine group (1 (1.7%) vs 12 (18.5%), p=0.002 and 16 (27.6%) 38 (58.5%), p=0.001, respectively). The incidence of postoperative nausea and vomiting was significantly less in the lidocaine group compared with the proparacaine group (6 (10.3%) vs 16 (24.6%), p=0.04). There were no differences between the groups in terms of incidence and severity of the oculocardiac reflex. We conclude that, compared with proparacaine 0.5% eye drops, a single application of lidocaine 2% gel improves peri-operative analgesia and reduces the incidence of postoperative nausea and vomiting in elective paediatric squint surgery.
Topics: Adolescent; Anesthesia, General; Anesthetics, Local; Child; Child, Preschool; Female; Gels; Humans; Incidence; Lidocaine; Male; Monitoring, Intraoperative; Ophthalmic Solutions; Ophthalmologic Surgical Procedures; Pain Measurement; Pain, Postoperative; Postoperative Nausea and Vomiting; Propoxycaine; Prospective Studies; Reflex, Oculocardiac; Strabismus; Treatment Outcome
PubMed: 24044387
DOI: 10.1111/anae.12286 -
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 -
Academic Emergency Medicine : Official... 1994To compare two topical eye anesthetics, proparacaine and tetracaine, for pain of instillation and duration of activity. (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
OBJECTIVE
To compare two topical eye anesthetics, proparacaine and tetracaine, for pain of instillation and duration of activity.
METHODS
Volunteers received both anesthetics in a prospective, randomized, double-masked protocol. The subjects were given one drop of a study solution in the lower lid fornix of the left eye. Immediately after receiving the medication, they rated the pain of instillation on a previously validated visual-analog pain scale. This procedure was then repeated in the right eye with the other study solution. Pain scales were quantified by making measurements to the nearest millimeter from the point of scale origin to the point marked by the patient. The time interval until return of the corneal blink reflex was determined using a cotton wisp. Pain scores and the time to return of corneal reflex were analyzed by the Sign test and Wilcoxon rank-sum test, respectively, with significance defined as p < 0.05.
RESULTS
Twenty-three subjects were available for analysis. Twenty subjects reported proparacaine hurt less than tetracaine, two felt the pain was the same for the two agents, and only one reported that proparacaine was more painful. The mean pain score for tetracaine was 24 mm (100 mm maximum) higher than that for proparacaine (p < 0.0002). Proparacaine lasted 1.3 minutes longer than tetracaine, 10.7 minutes versus 9.4 minutes (p = 0.0001).
CONCLUSION
Proparacaine eye drops cause less pain than tetracaine eye drops upon instillation. Anesthesia from proparacaine last slightly longer. These properties make proparacaine preferable to tetracaine.
Topics: Administration, Topical; Adult; Anesthetics, Local; Double-Blind Method; Evaluation Studies as Topic; Eye; Humans; Pain Measurement; Propoxycaine; Prospective Studies; Tetracaine
PubMed: 7614283
DOI: 10.1111/j.1553-2712.1994.tb02646.x -
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