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Cefazolin-lidocaine mixture in retinal surgery shows no pain-relieving benefit
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Adding lidocaine to subconjunctival cefazolin in pars plana vitrectomy, with or without phacoemulsification, yielded no analgesic benefit, according to a study.
The randomized, single-masked clinical trial evaluated 54 patients who were naïve to ophthalmic surgery and required retinal surgery at Toronto Western Hospital. Subjects were randomly assigned to receive a subconjunctival injection of either 0.3 mL cefazolin and 0.2 mL balanced salt solution or 0.3 mL cefazolin and 0.2 mL lidocaine 2% at the end of retinal surgery.
Subjects were later asked to rate their pain at the beginning of surgery, during the middle of surgery, at the end of surgery immediately before the injection and immediately postoperatively after the injection.
Patients in both groups reported little to no pain throughout the surgical process. There were no statistically significant differences in pain between the two groups at the various time points.
“The majority of patients in the group receiving cefazolin alone reported a pain level of ‘0’ after the subconjunctival injection and postoperatively,” the study authors wrote. “This may suggest that there is little discomfort associated with the subconjunctival delivery of cefazolin, or local anesthetic provided sufficient analgesia.”
The study’s limitations included the fact that pain was rated retrospectively and subjectively. – by Rebecca L. Forand
Disclosures: The authors report no relevant financial disclosures.
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Mak MYK, et al. Ophthalmic Surg Lasers Imaging Retina. 2017;doi:10.3928/23258160-20171030-02.
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