Comparison of Topical Anesthesia, Intracameral 1% Lignocaine and Topical Anesthesia and Intravenous Acetaminophen and Topical Anesthesia for Phacoemulsification in Cataract Surgery

Abstract

Objective: To compare the effectiveness of topical Proparacaine 0.5%, topical Proparacaine 0.5% and topical Proparacaine 0.5% for intraoperative analgesia and surgeon’s score undergoing simple cataract surgery. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anaesthesia, Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan,from Sep 2022 to Mar 2023. Methodology: Sixty patients aged 40 years and more, ASA-l and ll, undergoing elective simple cataract surgeries were observed by taking 20 patients in all three groups (n=20). Group-T: Topical Anesthesia group, 0.5% Proparacaine Group-I: Topical Anesthesia & Intracameral 1% Lignocaine Group-A: Topical Anesthesia and IV Acetaminophen groups were randomly allocated for pretreatment to either receive the 0.5% Proparacaine Eye drops (Group-T) or 0.5%Proparacaine eye drops with Intracameral 1ml 1% Lignocaine (I group) or 0.5% Proparacaine Eye drops with intravenous Acetaminophen 15ml/kg (A group). Incidence of pain by Visual analogue scale/wong-baker faces scale was noted. The surgeon’s comfort was assessed by using Gupta’s surgeon score questionnaire. Results: The results showed Group-I had better analgesic score than Group-T with only 1(5%) patient had a score of 4 but even more significant efficacy of intravenous acetaminophen plus topical anesthesia (Group-A) was shown as compared to rest of the groups with none (0%) patient had a VAS score of 4 (p-value=0.002). The results also showed Group-I had better surgeon comfort score than both Group-T and Group-A, with only 1(5%) patient had a score of 7 or above as compared to Group-T, 9(45%) patients and Group-A 7(35%) patients. (p-value=0.005). Conclusion: Intravenous acetaminophen plus topical