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Impressum
Subconjunctival anesthesia using cocaine and mepivacaine in cyclocryocoagulation
Mielke J., Schlote T.
University Eye Hospital, Tübingen, Germany
Objective: Retro- or peribulbar anesthesia are the standard procedures
for cyclodestructive surgery. Because these methods of anesthesia may
further compromise optic nerve function, escpecially in advanced glaucoma,
subconjunctival anesthesia was evaluated as an alternative procedure in
cyclocryocoagulation (CCC).
Methods: A prospective study concerning CCC in advanced glaucoma
was started using subconjunctival anesthesia with 5% cocaine (group 1)
or 2% mepivacaine (group 2) in 25 eyes of 25 patients in each group. Pain
during CCC using a 10-point-rating-scale and adverse events were recorded.
Results: Group1 (cocaine) - 92% of patient experienced no pain,
8% of patients reported very mild pain (point 2 of the rating scale).
One patient reported nausea, 4 patients mouth dryness. Group 2 (mepivacaine)
- 80% experienced no pain, 12% very mild pain (point 2), 8% mild pain
(point between 2.5 and 3). There were no systemic side effects. In all
50 patients, no complications were observed and no retro- or parabulbar
anesthesia was needed.
Conclusion: Most of the patients experienced no pain during CCC
using subconjunctival anesthesia. Therefore, risks and side effects of
retro- or parabulbar anesthesia can be successfully avoided by this modification.