April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Which Anesthesia Method is Best for Minimizing Pain from Intravitreal Injections?
Author Affiliations & Notes
  • Ronald E. Frenkel
    Ophthalmology,
    East Florida Eye Institute, Stuart, Florida
    Bascom Palmer Eye Institute, Miami, Florida
  • Max P. Frenkel
    East Florida Eye Institute, Stuart, Florida
    Eye Research Foundation, Stuart, Florida
  • Marlon J. Demeritt
    East Florida Eye Institute, Stuart, Florida
    Eye Research Foundation, Stuart, Florida
  • Footnotes
    Commercial Relationships  Ronald E. Frenkel, None; Max P. Frenkel, None; Marlon J. Demeritt, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 1694. doi:
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    • Get Citation

      Ronald E. Frenkel, Max P. Frenkel, Marlon J. Demeritt; Which Anesthesia Method is Best for Minimizing Pain from Intravitreal Injections?. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1694.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To determine which method of anesthesia is best for Intravitreal injections (IVT).

Methods: : A retrospective review was done of 46 patient charts who pre-injection receivedeither Topical + Cotton pledget (TC), Topical + Gel (TG), Gel alone (G), or Topical + Subconjunctival (TS). Topical consisted of one drop of proparacaineimmediately followed by one drop of tetracaine 0.5%. Pledgets were soaked inlidocaine 4% and applied for 30 sec X 3. Gel was tetravisc 0.5% applied for 3" X 2.Subconjunctival waslidocaine 2% without epinephrine using a 30G needle. Patients were asked to separately grade the degree of pain of the anestheticdelivery itself, the injection, and pre-discharge using the Visual Analog Pain Scale.Average pain was calculated as the mean of categories 1-3. Each method was statistically compared to each other in each of the 4 categories: 1) Anesthetic delivery pain, 2) Injection pain, 3) Post-injection pain, and 4) Average overall pain.

Results: : The Anesthesia Delivery Pain, Injection Pain, Post-Injection Pain, Average Pain; for each group was respectively;Topical + CTA, 1.22 +/- 1.80, 1.44 +/- 2.25, 0.50 +/- 1.20, 1.05 +/- 1.82Topical + Gel, 0.45 +/- 1.20, 1.00 +/- 1.35, 0.09 +/- 0.28, 0.51 +/- 1.12*Gel, 0.22 +/- 0.66, 2.44 +/- 2.70, 0.22 +/- 0.44, 0.96 +/- 1.89Topical + Sub Conj. Injection, 0.37 +/- 0.74, 0.25 +/- 0.46*, 1.00 +/- 1.60, 0.54 +/- 0**Statistically significant differences were found only between the following groups:Injection pain was less in TS vs. G, p=.019. Post-injection pain was less in TG vsTS, p=.040. Average pain was statistically less in TG vs TC, p=.048 and TS vs. TC p=.048.

Conclusions: : Injection pain was least with Topical + Subconjunctival. Overall average pain was less in both the Topical + Subconjunctival groups andthe Topical+ Gel groups.

Keywords: injection • retina • age-related macular degeneration 
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