Study: No effect from intracameral lidocaine on cataract surgery pain

Preoperatively administering intravenous sedation may be more important than using intracameral lidocaine for alleviating discomfort and pain during small-incision cataract surgery, a study suggests.

Juha Välimäki, MD, PhD, of the Central Hospital of Lahti, Finland, randomly assigned 96 patients to receive either 0.5 cc of balanced salt solution or 1% unpreserved lidocaine during cataract surgery. Any patient who also wanted to be sedated received intravenous midazolam hydrochloride, according to the study.

Both groups had similar average scores for pain — 0.73 in the control group and 0.54 in the lidocaine group out of a possible total score of 3. Also, 83% of the control group and 92% of the lidocaine group reported either no discomfort or only mild discomfort.

However, "logistic regression analysis showed a significant relationship between pain scores and intravenous sedation but not with intracameral lidocaine or other tested variables," Dr. Välimäki said, noting that both groups were comparable in need for sedation.

The odds ratio for pain increased to 5.1 among nonsedated patients compared with those who were sedated, Dr. Välimäki reported.

The study is published in the May/June issue of European Journal of Ophthalmology.