Study about Topical Anesthesia with Ropivacaine and Proparacaine for Intravitreal Injection Procedures | Chapter 16 | New Horizons in Medicine and Medical Research Vol. 4

 The goal of this study was to compare the efficacy of ropivacaine in combination with proparacaine as a topical anaesthetic for intravitreal injections to proparacaine alone.

Prospective study was used as a method. We evaluated proparacaine 0.5 percent +ropivacaine 0.2 percent (AM 1) and proparacaine 0.5 percent alone (AM 2). (AM 2). One hundred and fifty-five patients were randomly assigned to one of three groups after receiving intravitreal injections: Patients in Group 1 underwent bilateral same-day intravitreal treatment with various anaesthetic methods for each eye and pain experience was evaluated between the two eyes. Groups 2 and 3 underwent unilateral therapy, topical anaesthesia using anaesthetic methods 1 and 2, and were asked to rate their pain sensation. A 0 to 10 pain scale was utilised, with 0 representing no pain and 10 signifying severe agony.

The 38 patients (76 eyes) in the first group were given different anaesthetic for each eye before receiving a same-day bilateral intravitreal injection with a 30-gauge needle. The average pain score for AM 1 was 2.612.021, while for AM 2 it was 3.262.522. There was a statistically significant difference in pain scores between the two anaesthetic procedures (P=0.039). The average pain score for group 2 was 2.381.795, while it was 2.662.014 for group 3 (P=0.426).

Conclusion: We believe that combining proparacaine 0.5 percent, a short-acting anaesthetic, with ropivacaine 0.2 percent, a long-acting anaesthetic, is an effective anaesthetic option that provides patients with high rates of pain control and overall satisfaction during the office-based intravitreal injection procedure, and may be superior to proparacaine 0.5 percent alone. The development of ropivacaine's ophthalmic solution in the future would be tremendously advantageous, as it would provide yet another efficient technique of topical anaesthesia for a range of eye surgeries. 

Author(S) Details

Nektarios E. Klados
Department of Ophthalmology, 401 General Army Hospital of Athens, Athens, Greece and Institute of Vision & Optics, Faculty of Medicine, School of Health Scienc- es, University of Crete, Crete, Greece.

Dimitrios T. Kourkoutas
Department of Ophthalmology, 401 General Army Hospital of Athens, Athens, Greece.

Zoi G Kapsala
Institute of Vision & Optics, Faculty of Medicine, School of Health Scienc- es, University of Crete, Crete, Greece.

Eirini-Areti D. Giannopoulou
Institute of Vision & Optics, Faculty of Medicine, School of Health Scienc- es, University of Crete, Crete, Greece.

Miltiadis K. Tsilimbaris
Department of Ophthalmology, Faculty of Medicine, University Hospital of Heraklion, Crete, Heraklion, Greece and Institute of Vision & Optics, Faculty of Medicine, School of Health Scienc- es, University of Crete, Crete, Greece.

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