Comparison of Topical Proparacaine and Tetracaine Anesthesia for Intravitreal Ranibizumab Injections
Narrative Responses:
Purpose
To assess the efficacy of proparacaine 0.5% and tetracaine hydrochloride 0.5% as an anaesthetic during intravitreal injections of Ranibizumab.
To survey and compare ocular discomfort experienced by patients two to seven hours post procedure following use of proxymetacaine and tetracaine respectively.
Methods
Data were collected from Age-related Macular Degeneration clinics, Cwm Taf health board, South Wales, UK, over a period of four weeks (16th January 2013 to 13thFebruary 2013). Topical anaesthesia used were documented. Patients were unaware as to which anaesthetic was used. Patients were asked to rate the pain experienced following each injection from a scale of 0-10 (0 –no pain, 10- worst pain).
Patients were contacted in the evening and asked to rank pain/discomfort as no pain, mild/gritty sensation, moderate pain and severe pain.
Virgin eyes and non-Ranibizumab injections were excluded.
Results
121 patients were included in the study. Proparacaine (P) had 64 patients and Tetracaine (T) had 57 patients. There were no significant difference in the pain score for the two groups, T was 0.91 and P, 1.12 (p= 0.549). No delayed discomfort were experienced in 53.6% in group P and 37.0% in group T (p=0.1247 Fisher’s Exact).
Conclusion
Proparacaine and tetracaine are equally effective in providing anaesthesia for intravitreal procedures. Proparacaine was more likely to result in no discomfort later in the day as opposed to tetracaine however the results were not significant.