Intracameral anesthesia: a report by the American Academy of Ophthalmology

C L Karp; T A Cox; M D Wagoner; R G Ariyasu; D S Jacobs

doi:10.1016/S0161-6420(01)00793-X

Back

Intracameral anesthesia: a report by the American Academy of Ophthalmology

Journal article

Peer reviewed

Intracameral anesthesia: a report by the American Academy of Ophthalmology

C L Karp, T A Cox, M D Wagoner, R G Ariyasu and D S Jacobs

Ophthalmology (Rochester, Minn.), Vol.108(9), pp.1704-1710

09/2001

DOI: 10.1016/S0161-6420(01)00793-X

PMID: 11535476

View Online

Abstract

This document describes the technique of intracameral anesthesia and examines the available evidence to address questions about its effectiveness, possible corneal endothelial and retinal toxicity, and the optimal and maximal dose. A literature search conducted for the years 1968 to 2000 retrieved over 180 citations that matched the search criteria. Panel members and a methodologist reviewed this information, and it was evaluated for the quality of the evidence presented. Some studies report effectiveness of intracameral anesthesia while others report no effect. In those studies showing an effect, levels of pain in the groups that were compared were low. Short-term studies seem to indicate that preservative (methylparaben)-free lidocaine 1% is well tolerated by the corneal endothelium but that higher concentrations of lidocaine are toxic. There is some evidence of electroretinogram changes after exposure to lidocaine or bupivacaine. The ideal timing and placement of intracameral anesthesia has not been determined. Because topical anesthesia alone is effective, surgeons may elect to use intracameral anesthesia for incremental pain control in patients who cannot be adequately managed with topical alone. Appropriate patient selection is important when using this method of anesthesia. While short-term studies seem to indicate safety, long-term effects are unknown. Patient preferences for anesthesia are not well studied.

Retina - drug effects

Lidocaine - adverse effects

Ophthalmology - standards

Humans

Bupivacaine - administration & dosage

Anterior Chamber - drug effects

Endothelium, Corneal - drug effects

Lidocaine - administration & dosage

Randomized Controlled Trials as Topic

Technology Assessment, Biomedical

Time Factors

Anesthetics, Local - adverse effects

Anesthetics, Local - administration & dosage

Safety

Bupivacaine - adverse effects

Societies, Medical - standards

Anesthesia, Local - methods

Details

Title: Subtitle: Intracameral anesthesia: a report by the American Academy of Ophthalmology
Creators: C L Karp
T A Cox
M D Wagoner
R G Ariyasu
D S Jacobs
Resource Type: Journal article
Publication Details: Ophthalmology (Rochester, Minn.), Vol.108(9), pp.1704-1710
DOI: 10.1016/S0161-6420(01)00793-X
PMID: 11535476
NLM abbreviation: Ophthalmology
ISSN: 0161-6420
eISSN: 1549-4713
Publisher: United States
Language: English
Date published: 09/2001
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983980044102771

Metrics

27 Record Views

33 Times Cited - Web of Science