Painless Needle Insertion in Regional Anesthesia of the Eye

• Published in: Anesthesia and analgesia Vol. 80; no. 4; pp. 678 - 681
• Main Authors: Vaalamo, Mikko O., Paloheimo, Markku P.J., Nikki, Pertti H.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01.04.1995; Lippincott
• Subjects: Adult; Aged; Aged, 80 and over; Anesthesia, Conduction - methods; Anesthetics, Local - administration & dosage; Anesthetics. Neuromuscular blocking agents; Biological and medical sciences; Double-Blind Method; Electromyography; Eye; Female; Humans; Lidocaine - administration & dosage; Male; Medical sciences; Middle Aged; Neuropharmacology; Pain Measurement; Pharmacology. Drug treatments; Procaine - administration & dosage; Procaine - analogs & derivatives; Sodium Chloride - administration & dosage; Local anesthetic; Human; Eye; Analgesia; Pain; Needle; Local anesthesia; Insertion; Conjunctiva; Comparative study
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1097/00000539-199504000-00005

We examined a new technique of applying topical anesthetic with cotton tip sticks to the conjunctiva before needle insertion in regional anesthesia of the eye.Oxybuprocaine 0.4% and lidocaine 4% were compared with balanced salt solution (BSS) as topical anesthetics of the conjunctiva in Study 1. Ninety patients were randomly assigned into three groups (n = 30) to receive one of the three topical anesthetics in a double-blind manner. Pain of the needle insertions was measured with visual analog scale score (VAS) and quantitative surface electromyography (qEMG). Both oxybuprocaine and lidocaine reduced pain significantly when compared to BSS. In Study 2, with healthy volunteers, we compared our previous practice of merely applying three consecutive drops of oxybuprocaine on the conjunctiva before needle insertions to the new technique of placing additional cotton tip sticks soaked in oxybuprocaine on the conjunctiva. We found the needle insertion virtually pain free when the cotton tip sticks were added to the topical anesthesia. The use of this simple method of topical anesthesia before the eye block increases patient comfort significantly.(Anesth Analg 1995;80:678-81)