Systemic levels of lidocaine after intracameral injection during cataract surgery

Abstract

Purpose To evaluate the systemic concentrations of lidocaine after intracameral injection of a 1% solution during cataract surgery and the safety of this application mode. Setting Department of Ophthalmology, Medical University of Lübeck, Lübeck, Germany. Methods This prospective study included 10 patients who had phacoemulsification and posterior chamber lens implantation with a self-sealing scleral tunnel incision. Topical anesthesia was achieved using cocaine 10% eyedrops combined with 0.5mL of unpreserved lidocaine 1% injected into the anterior chamber. Blood samples were taken from all patients at predetermined intervals before and during the procedure. Consecutive analysis for lidocaine was performed with gas chromatography. Results In all samples, serum lidocaine concentrations were below a minimum detectable level of 100 ng/mL. No local or systemic intraoperative or postoperative complications were noted. Conclusions Intracameral injection of 0.5 mL lidocaine 1% revealed no systemic therapeutic concentrations. In patients in whom other forms of needle-delivered local anesthesia are contraindicated, intracameral injection of lidocaine should be considered to enhance topical anesthesia.