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The effectiveness of lidocaine vs tetracaine as topical anesthetic agents for removal of corneal stitches

Authors:Ahmed E.Khatatbeh, Walid N. Qubain
Int J Biol Med Res. 2012; 3(2): 1512-1515  |  PDF File

Abstract

Abstract Aim: to compare the effectiveness of the use of topical lidocaine 1% compared to topical tetracaine 1% anesthesia for removal of corneal stitches in postoperative extra- capsular cataract extraction. Method: Single-masked, randomized prospective study performed in two Royal Medical Services hospitals in Jordan ;prince Rashed bin Alhassan hospital and Prince Ali bin Al-hussein hospital between August 2011 and January 2012. All patients previously underwent extra capsular cataract extraction surgery and scheduled for removal of corneal stitches were included in this study, patient with previous external ocular inflammatory conditions and those with previous use of any topical ophthalmic medications were excluded from this study. One hundred patients who fit the inclusive criteria were divided into 2 equal groups the 1st group (group A) are those who received topical lidocaine 1% and the 2nd group (group B) are those who received topical tetracaine 1%. The topical medication of each type was installed into the lower eye fornix and the Patients in both groups were reviewed regarding stinging sensation, onset of action of the topical anesthesia, pain sensation during stitches removal and duration of the whole procedure. Results: In group A; patients experienced stinging sensation for 4 to13 second (average 8 seconds) with onset of action ranged from 60 to 270 seconds (average 130 seconds), 72% of patients didn't experience any pain, 22% felt mild tolerable pain, 6%of patients continued suffering from severe pain and the average time required for the complete removal of the stitches was 184 seconds. In group B; patients experienced stinging sensation for 7 to21 second (average 17 seconds) with onset of action ranged from 210 to 540 seconds (average 380 seconds), 52% of patients didn't experience any pain, 28% felt mild tolerable pain, 20% of patients continued suffering from severe pain and the average time required for the complete removal of the stitches was 279 seconds. Conclusion: Lidocaine is one of the well tolerated and effective local anesthesia agents and showed its superiority to tetracaine in minor ophthalmic procedures; we recommend using it for corneal stitches removal in post cataract surgery patients.