The British journal of ophthalmology
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Randomized Controlled Trial Clinical Trial
Warming lignocaine reduces the pain of injection during peribulbar local anaesthesia for cataract surgery.
To test if the simple technique of warming lignocaine reduces the pain of injection during local anaesthetic cataract surgery. ⋯ The process of warming lignocaine to 37 degrees C has been found to reduce significantly the pain of injection during peribulbar local anaesthesia. It is recommended that this technique be more widely adopted in order to minimise patient's discomfort.
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Randomized Controlled Trial Comparative Study Clinical Trial
A double-masked evaluation of lignocaine-prilocaine cream (EMLA) used to alleviate the pain of retrobulbar injection.
A randomised, placebo controlled, double-masked study was undertaken in 115 patients undergoing cataract surgery to assess the efficacy of the anaesthetic cream EMLA (eutetic mixture of local anaesthetic, lignocaine-prilocaine) in alleviating the pain of retrobulbar injection. Sixty three patients received the EMLA cream and 52 the placebo cream. ⋯ Significantly lower pain scores were recorded in patients treated with EMLA cream (anaesthetist's observation: p less than 0.01, patient's assessment: p less than 0.006). No patients experienced serious side effects in either treatment group.
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Randomized Controlled Trial Clinical Trial
Attenuation of ocular and systemic responses to tracheal intubation by intravenous lignocaine.
This study was undertaken to determine whether intravenous lignocaine could mitigate or prevent the ocular reactions and especially the acute increase in intraocular pressure associated with laryngoscopy and tracheal intubation. Two groups of children undergoing minor eye surgery under nitrous oxide-oxygen-halothane anaesthesia were examined. The experimental group (n = 17) received 2 mg/kg lignocaine and the controls (n = 18) an equivalent volume of saline. ⋯ Other ocular reactions were recorded, and all were attenuated after lignocaine administration. The beneficial effects of lignocaine, a suppressant of autonomic reflexes, suggest that intraocular pressure, like the heart rate, rises after intubation as a result of autonomic stimulation. The use of intravenous lignocaine is thus recommended for children at risk, such as those needing an urgent operation because of lacerated eye injury under rapid sequence induction of anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative efficacy of orally and topically administered beta blockers for chronic simple glaucoma.
This open study of beta blockers in chronic simple glaucoma compared the efficacy of once daily (o.d.) oral nadolol therapy with twice daily (b.d.) topical timolol therapy. Sixty eight patients were randomly assigned to starting doses of either 20, 40, or 80 mg of nadolol o.d. (51 patients) or 0.25% timolol b.d. (17 patients) and were seen at weekly intervals for a four-week (short-term) period. Upward dosage titration (80 mg o.d. maximum, nadolol and 0.5% b.d. maximum, timolol) was permitted if, at any visit, the intraocular pressure (IOP) in either eye was greater than 21 mmHg. ⋯ Long-term therapy (up to 24 months) in 28 nadolol patients and 5 timolol patients indicates no more likelihood of tolerance with nadolol therapy. Patient withdrawals from the study due to adverse reactions occurred with nadolol but not timolol. Since oral nadolol administered once daily is as efficacious as b.d. topical timolol, it can be recommended as first-line therapy for certain subsets of the glaucoma clinic population.