Comparison of lidocaine 2% gel versus amethocaine as the sole anesthetic agent for strabismus surgery

Abstract

Purpose To compare the efficacy of lidocaine 2% gel with amethocaine 1% eyedrops as the sole anesthetic agent for one-stage adjustable suture strabismus surgery. Design Prospective, double-masked randomized trial. Participants Fourteen consecutive patients scheduled to undergo bilateral and symmetrical strabismus surgery under topical anesthesia in one institution. Methods Each patient was randomized to receive lidocaine 2% gel in one eye and amethocaine 1% eyedrops in the other eye as the sole anesthetic agent for surgery. Masking of the patient and surgeon was ensured by administration of a placebo gel and eyedrop as part of the regimen. Pain and discomfort were assessed via a 10-cm visual analog scale. Main outcome measures Subjective pain and discomfort perceived during surgery were assessed separately by the patient and the surgeon, and the need for any additional anesthesia was recorded. Results A total of 14 subjects indicated mean pain and discomfort scores of 2.6 and 3.2 respectively, for lidocaine gel, and 5.3 and 6.2, respectively, for amethocaine drops ( P = 0.01). The mean number of additional drops required by eyes randomized to lidocaine gel was 0.3, compared with 1.6 for amethocaine drops ( P = 0.02). Conclusions In terms of pain control, lidocaine 2% gel alone is a superior topical anesthetic for one-stage adjustable suture strabismus surgery when compared with amethocaine 1% eyedrops.