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Topical anesthesia may be less effective than regional anesthesia during phaco
Topical anesthesia is less effective than regional anesthesia for pain suppression during phacoemulsification, despite achieving similar surgical outcomes, according to a study.
The retrospective literature review of 15 published studies included 1,084 eyes that received topical anesthesia and 1,121 eyes that received retrobulbar or peribulbar anesthesia. Primary outcome parameters were pain scores during and after surgery, intraoperative difficulties and inadvertent ocular movement, intraoperative necessity to administer additional anesthesia, and patient preference.
Significantly greater pain was perceived in the topical anesthesia group (P < .05), which also required more frequent supplementary anesthesia (P = .03) and showed more inadvertent ocular movement (P .05). However, topical anesthesia was significantly preferred by patients over regional anesthesia (P < .00001), which reduced injection-related complications and alleviated patients’ fear of injection.
“The choice of topical anesthesia is not suitable for specific patients,” the study authors said. “In patients with a higher initial blood pressure and younger patients who are more susceptible to pain, topical anesthetic alone should be avoided and alternative anesthetic methods are recommended.”