Comparison between topical anaesthesia with cocaine versus lidocaine plus adrenaline for outpatient laser dacryocystorhinostomy

Archivos de la Sociedad Española de Oftalmología
F AlañónGuillermo Plaza

Abstract

To evaluate the effectiveness of topical anaesthesia with cocaine versus lidocaine plus adrenaline for outpatient transcanalicular and endonasal dacryocystorhinostomy (TCLDCR) with diode laser under sedation. A double blind randomised clinical trial was designed using topical anaesthesia for outpatient TCLDCR in the treatment of adult epiphora. A total of 92 patients were enrolled, and randomly allocated to be operated on under sedation and topical anaesthesia with cocaine 4% pledgets versus sedation and topical anaesthesia with lidocaine 2% plus 1/100.000 adrenaline pledgets. Main outcome measures were postoperative comfort, evaluated by a visual analogue scale, presence of secondary effects (blood pressure, heart rate), and resolution of epiphora, evaluated by Munk's scale and endoscopic control. Patients in both groups reported being comfortable during and immediately after TCLDCR. Visualization of the operative field was adequate, and surgery was successfully completed in all cases. Complications were more common in the cocaine group: Sixteen patients from the cocaine group had high blood pressures, versus 2 patients from the lidocaine group (RR=8). Mean blood loss was 6.09 ml in cocaine group, versus 2.05 ml in lidocaine g...Continue Reading

References

Aug 1, 1991·Ophthalmic Surgery·S R Seiff
May 1, 1980·Archives of Ophthalmology·E F Meyers
Oct 1, 1995·Anesthesia and Analgesia·A D NoorilyR A Otto
May 29, 2000·Ophthalmic Plastic and Reconstructive Surgery·D R Meyer
May 24, 2007·Ophthalmic Plastic and Reconstructive Surgery·Guillermo PlazaAraceli Nogueira

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