Abstract
Purpose :
This review investigates the use of anesthesia in the surgical treatment of diabetic retinopathy, focusing on pain management, patient comfort, and procedural success. This investigation analyzes various surgical interventions commonly employed for advanced diabetic retinopathy.
Methods :
The PubMed database was reviewed for literature pertaining to Diabetic Retinopathy and Anesthetics. The exact search phrases "Diabetic retinopathy and lidocaine," "Diabetic retinopathy and proparacaine," "Diabetic retinopathy and procaine," "Diabetic retinopathy and tetracaine," "Diabetic retinopathy and bupivacaine", and “Diabetic retinopathy and xylocaine” were applied to all time periods. This resulted in a total of 48 publications, of which 29 were unique and not duplicates, 24 had full texts available, 19 were topically relevant, and only 19 satisfied our evaluation's analysis standards. The information acquired from these 19 investigations included the types of treatment used, type of anesthetic, dosage, area of application, and patient outcomes. This action was taken to eliminate any personal bias. In Figure 1, the authors of this research present a more comprehensive illustration of the filtration process.
Results :
Lidocaine emerged as the most frequently used anesthetic, demonstrating effectiveness in reducing pain and systolic pressure during panretinal photocoagulation and posterior vitrectomy. There was a statistically significant difference in the dosage of lidocaine (2.33 ± 1.00%) vs other alternative anesthetics (0.475 ± 0.05%) for surgical procedures used to treat diabetic retinopathy. The topical application of lidocaine was preferred for its ease of administration and reduced risk of complications. Povidone, frequently co-administered, contributed to maintaining aseptic conditions during intravitreal injections, ensuring patient safety.
Conclusions :
The positive post-surgery outcomes, emphasizing effective pain management and reduced systolic pressure, align with lidocaine's well-established efficacy and versatility. The study suggests lidocaine as a suitable choice for diabetic retinopathy procedures. Exploration of lidocaine's impact, considering patient medical history, and examining a wider range of co-administered drugs is recommended for comprehensive insights into optimizing patient outcomes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.