Anesthesia for Intravitreal Injection: A Systematic Review

Jonathan Han, Nicholas T Rinella, Daniel L Chao Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USACorrespondence: Daniel L ChaoShiley Eye Institute, 9415 Campus Point Drive, La Jolla, CA 92093, USATel +1 858 534-6290Fax +1 858 534-...

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Autores principales:	Han J, Rinella NT, Chao DL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	intravitreal injection anesthesia pain management review Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/f40eb63251494546ad57dbab2b3b79a7
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spelling	oai:doaj.org-article:f40eb63251494546ad57dbab2b3b79a72021-12-02T09:55:23ZAnesthesia for Intravitreal Injection: A Systematic Review1177-5483https://doaj.org/article/f40eb63251494546ad57dbab2b3b79a72020-02-01T00:00:00Zhttps://www.dovepress.com/anesthesia-for-intravitreal-injection-a-systematic-review-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Jonathan Han, Nicholas T Rinella, Daniel L Chao Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USACorrespondence: Daniel L ChaoShiley Eye Institute, 9415 Campus Point Drive, La Jolla, CA 92093, USATel +1 858 534-6290Fax +1 858 534-7985Email dlchao@ucsd.eduBackground: The intravitreal injection has become one of the most commonly performed procedures in ophthalmology; however, there is no standardized approach to anesthesia during the procedure. The goal of this systematic review is to review approaches to anesthesia for intravitreal injection and look at comparative efficacy between these different anesthetics.Methods: A systematic review of literature was performed in the MEDLINE, PubMed, Cochrane Library, and Clinicaltrials.gov databases using the key words “anesthesia”, “pain management”, and “intravitreal injection”. Of the initial 239 search matches, 30 articles were found to be relevant to the topic. 18 studies were excluded as they did not include primary data or did not include the visual analog scale as a primary outcome. The remaining 12 articles were assessed to look at the comparative efficacy of anesthesia and adverse events.Results: The anesthesia techniques reported include topical methods such as anesthetic eyedrops, anesthetic gels, and anesthetic-soaked pledgets as well as subconjunctival injection of anesthetic. Ultimately, no single anesthetic or delivery mechanism was shown to be superior to the others in a statistically significant way and adverse events were largely insignificant. Limitations of these studies include relatively small sizes of the studies, as well as the lack of masking which may introduce bias.Conclusion: In the current literature, no type of anesthetic method was found to be superior to another for intravitreal injection. Future studies in this area may lead to new insights into the efficacy of different forms of intravitreal anesthesia.Keywords: intravitreal injection, anesthesia, pain, management, reviewHan JRinella NTChao DLDove Medical Pressarticleintravitreal injectionanesthesiapainmanagementreviewOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 543-550 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	intravitreal injection anesthesia pain management review Ophthalmology RE1-994
spellingShingle	intravitreal injection anesthesia pain management review Ophthalmology RE1-994 Han J Rinella NT Chao DL Anesthesia for Intravitreal Injection: A Systematic Review
description	Jonathan Han, Nicholas T Rinella, Daniel L Chao Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USACorrespondence: Daniel L ChaoShiley Eye Institute, 9415 Campus Point Drive, La Jolla, CA 92093, USATel +1 858 534-6290Fax +1 858 534-7985Email dlchao@ucsd.eduBackground: The intravitreal injection has become one of the most commonly performed procedures in ophthalmology; however, there is no standardized approach to anesthesia during the procedure. The goal of this systematic review is to review approaches to anesthesia for intravitreal injection and look at comparative efficacy between these different anesthetics.Methods: A systematic review of literature was performed in the MEDLINE, PubMed, Cochrane Library, and Clinicaltrials.gov databases using the key words “anesthesia”, “pain management”, and “intravitreal injection”. Of the initial 239 search matches, 30 articles were found to be relevant to the topic. 18 studies were excluded as they did not include primary data or did not include the visual analog scale as a primary outcome. The remaining 12 articles were assessed to look at the comparative efficacy of anesthesia and adverse events.Results: The anesthesia techniques reported include topical methods such as anesthetic eyedrops, anesthetic gels, and anesthetic-soaked pledgets as well as subconjunctival injection of anesthetic. Ultimately, no single anesthetic or delivery mechanism was shown to be superior to the others in a statistically significant way and adverse events were largely insignificant. Limitations of these studies include relatively small sizes of the studies, as well as the lack of masking which may introduce bias.Conclusion: In the current literature, no type of anesthetic method was found to be superior to another for intravitreal injection. Future studies in this area may lead to new insights into the efficacy of different forms of intravitreal anesthesia.Keywords: intravitreal injection, anesthesia, pain, management, review
format	article
author	Han J Rinella NT Chao DL
author_facet	Han J Rinella NT Chao DL
author_sort	Han J
title	Anesthesia for Intravitreal Injection: A Systematic Review
title_short	Anesthesia for Intravitreal Injection: A Systematic Review
title_full	Anesthesia for Intravitreal Injection: A Systematic Review
title_fullStr	Anesthesia for Intravitreal Injection: A Systematic Review
title_full_unstemmed	Anesthesia for Intravitreal Injection: A Systematic Review
title_sort	anesthesia for intravitreal injection: a systematic review
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/f40eb63251494546ad57dbab2b3b79a7
work_keys_str_mv	AT hanj anesthesiaforintravitrealinjectionasystematicreview AT rinellant anesthesiaforintravitrealinjectionasystematicreview AT chaodl anesthesiaforintravitrealinjectionasystematicreview
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Anesthesia for Intravitreal Injection: A Systematic Review

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