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M.M. Carrillo, G.E. Trope, D. Faingold, Y.M. Buys; Topical Anaesthesia in Trabeculectomy Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1204.
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Purpose: To compare the analgesic properties of Lidocaine 2% jelly versus sub-tenon's anaesthesia with Lidocaine 2% without epinephrine for trabeculectomy. Methods: Patients scheduled for trabeculectomy surgery were randomly assigned to topical Lidocaine 2% jelly or sub-tenon's anaesthesia with 2% Lidocaine. Both groups received a standardized sedative. Patients comfort, physicians assessment of intra-operative patient compliance, volume of local anesthetic used, need for supplemental anaesthesia and any complications were recorded. The Visual Analogue Scale (VAS) was utilized to measure intra-operative pain. The two groups were compared using the student t-test. Results: 50 patients were enrolled in the study, 25 in each group. The sub-tenon's anaesthesia group and the Lidocaine 2% jelly study group did not vary significantly in subjective pain score (1.75 +/- 1.62 vs 1.62 +/- 1.24 respectively, p=0.38), and surgeons satisfaction scale (3.5 +/- 0.7 vs 3.8 +/- 0.6 respectively, p=0.1). 4 patients required additional anesthesia all of them in the sub-tenon's group. The incidence of subconjunctival hemorrhage was the same (12%, n=3) in each group. Corneal epithelial defects were seen in 8% (n=2) of patients in the Lidocaine jelly group. Conclusions: Topical Lidocaine 2% jelly is a safe and effective anaesthetic method for trabeculectomy. Lidocaine 2% jelly is similar to sub-tenon's anaesthesia in patient comfort and surgeon satisfaction.
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