Strabismus Surgery Under Lidocaine 2% Gel

Abstract

Purpose: : to evaluate lidocaine 2% gel efficacity in the strabismus. surgery

Methods: : 20 patients with horizontal muscles strabismus 4 with esotropia, 6 with exotropia were included in the study. Deviation angle was from 35 prisms to 50 prisms. ). The surgery was performed on 2 to 3 horizontal muscles per patient (mean 2.75). All were adult patients. 19 cases were 1^st surgery, 1 case was 2^nd surgery. All cases were operated under lidocaine 2% gel local anesthesia. The perception of discomfort or pain was evaluated by all patients between 1 (very painful) and 10 (no subjective discomfort) during the surgery and the patients satisfaction was estimated the same way on the day one. The difficulty of performing the procedure was evaluated by two operating surgeons between 1 (very difficult) and 4 (very easy to perform the surgical intervention). The patient’s compliance during surgery was evaluated between 1 (no compliance) and 10 (good compliance). The time of stay in operating room was compared between 20 cases of topical anesthesia by adult patients of this study and 20 cases of standard strabismus surgery cases under general anesthesia of adult patients performed by the same surgeons. The satisfaction after surgical manipulation was evaluated as well on day 1 on the scale between 1 (a lot of subjective discomfort) and 10 (very satisfied).

Results: : the mean patient satisfaction was 8.5 during the surgery, the range was 6 to 10. The group of patients under local anesthesia presented higher subjective satisfaction rate as the patients under general anesthesia (p> 0.02). The difficulty of performing the surgery was evaluated by the first surgeon 3 (the range was 2 to 4). Three patients needed to be potentialised with Midazolam during the surgery. 1 patient potentialized by Midazolam was previously a drug abuser. The compliance of the patient correlated with difficulty of performing the surgery and patient satisfaction (p>0.02) and the surgeon’s experience with this surgical technique an important factor of the success.

Conclusions: : carefull selection of adult patients permits to perform the strabismus surgery under local anesthesia of Lidocaine 2% gel.

Clinical Trial: : hospital XV XX

Keywords: strabismus: treatment • strabismus