Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy

Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy

Majid Moshirfar,1 Mark D Mifflin,1 Michael V McCaughey,2 Adam J Gess1 1John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2University of New Mexico School of Medicine, Albuquerque, NM, USA Background: Tetracaine and proparacaine are two of the most commonly used medica...

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Autores principales: Moshirfar M, Mifflin MD, McCaughey MV, Gess AJ
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Lenguaje:EN
Publicado: Dove Medical Press 2014
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Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/e4f93bc1135840f98a1960ef2a51ef40
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spelling oai:doaj.org-article:e4f93bc1135840f98a1960ef2a51ef402021-12-02T02:48:23ZProspective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy1177-5483https://doaj.org/article/e4f93bc1135840f98a1960ef2a51ef402014-06-01T00:00:00Zhttp://www.dovepress.com/prospective-randomized-contralateral-eye-comparison-of-tetracaine-and--a17385https://doaj.org/toc/1177-5483 Majid Moshirfar,1 Mark D Mifflin,1 Michael V McCaughey,2 Adam J Gess1 1John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2University of New Mexico School of Medicine, Albuquerque, NM, USA Background: Tetracaine and proparacaine are two of the most commonly used medications for providing topical anesthesia in laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). These agents have not been previously compared in a prospective manner to determine their efficacy in these settings. Methods: This prospective, single-masked, randomized study comprised 256 eyes from 128 consecutive patients being treated with LASIK or PRK who were randomized to receive tetracaine in one eye and proparacaine in the other. The patients were blinded as to which anesthetic agent was used in each eye. Pain levels were graded on a 0–10 scale, and were assessed upon instillation, during surgery, immediately postoperatively, 30 minutes postoperatively, overnight, and on postoperative day 1. Patients were asked 30 minutes after surgery which anesthetic agent they would choose. Results: Both anesthetic agents resulted in diminished amounts of subjective pain in patients undergoing LASIK and PRK. Tetracaine caused significantly more pain upon instillation than proparacaine for both LASIK and PRK patients. LASIK patients noted significantly less pain 30 minutes after surgery when treated with tetracaine. Significantly more LASIK patients preferred the eye treated with tetracaine. These differences were not present in the PRK group. Conclusion: Both tetracaine and proparacaine are effective methods of topical anesthesia in LASIK and PRK. Tetracaine caused significantly more pain upon instillation in all patients, but resulted in greater analgesia 30 minutes after surgery in the LASIK group. Patients in the LASIK group expressed a preference for tetracaine over proparacaine. There was no significant drop preference among PRK patients. Keywords: tetracaine, pain control, laser in situ keratomileusis, photorefractive keratectomyMoshirfar MMifflin MDMcCaughey MVGess AJDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 1213-1219 (2014)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Moshirfar M
Mifflin MD
McCaughey MV
Gess AJ
Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy
description Majid Moshirfar,1 Mark D Mifflin,1 Michael V McCaughey,2 Adam J Gess1 1John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2University of New Mexico School of Medicine, Albuquerque, NM, USA Background: Tetracaine and proparacaine are two of the most commonly used medications for providing topical anesthesia in laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). These agents have not been previously compared in a prospective manner to determine their efficacy in these settings. Methods: This prospective, single-masked, randomized study comprised 256 eyes from 128 consecutive patients being treated with LASIK or PRK who were randomized to receive tetracaine in one eye and proparacaine in the other. The patients were blinded as to which anesthetic agent was used in each eye. Pain levels were graded on a 0–10 scale, and were assessed upon instillation, during surgery, immediately postoperatively, 30 minutes postoperatively, overnight, and on postoperative day 1. Patients were asked 30 minutes after surgery which anesthetic agent they would choose. Results: Both anesthetic agents resulted in diminished amounts of subjective pain in patients undergoing LASIK and PRK. Tetracaine caused significantly more pain upon instillation than proparacaine for both LASIK and PRK patients. LASIK patients noted significantly less pain 30 minutes after surgery when treated with tetracaine. Significantly more LASIK patients preferred the eye treated with tetracaine. These differences were not present in the PRK group. Conclusion: Both tetracaine and proparacaine are effective methods of topical anesthesia in LASIK and PRK. Tetracaine caused significantly more pain upon instillation in all patients, but resulted in greater analgesia 30 minutes after surgery in the LASIK group. Patients in the LASIK group expressed a preference for tetracaine over proparacaine. There was no significant drop preference among PRK patients. Keywords: tetracaine, pain control, laser in situ keratomileusis, photorefractive keratectomy
format article
author Moshirfar M
Mifflin MD
McCaughey MV
Gess AJ
author_facet Moshirfar M
Mifflin MD
McCaughey MV
Gess AJ
author_sort Moshirfar M
title Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy
title_short Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy
title_full Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy
title_fullStr Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy
title_full_unstemmed Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy
title_sort prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy
publisher Dove Medical Press
publishDate 2014
url https://doaj.org/article/e4f93bc1135840f98a1960ef2a51ef40
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AT mccaugheymv prospectiverandomizedcontralateraleyecomparisonoftetracaineandproparacaineforpaincontrolinlaserinsitukeratomileusisandphotorefractivekeratectomy
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