Lo Jeffrey Man Yeung, Li Veronica Yui Yan, Cheung Rachel Ka Ying, Chow Shing Chuen, Shih Kendrick Co, Fung Nicholas Siu Kay, Lam Wai-Ching
Department of Ophthalmology, Grantham Hospital, Hong Kong SAR, China.
Department of Ophthalmology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.
Int J Retina Vitreous. 2025 Mar 26;11(1):36. doi: 10.1186/s40942-025-00649-6.
To evaluate the potential adjunctive effect of pledget anesthetic to topical proparacaine applied in a droplet form in patients undergoing intravitreal injections (IVI).
This is a single-centre, prospective, randomized, double-blinded crossover study. 60 patients were included. Patients receiving IVI were given topical 0.5% proparacaine drops then randomized in a 1:1 ratio to receive 0.5% proparacaine soaked pledget or normal saline soaked pledget as placebo. The patients would later be crossed over to receive the alternative intervention. Pain was assessed with a visual analog scale (VAS) and questionnaire immediately afterwards, 10-minutes and 20-minutes after injection.
Pain intensity as assessed on the visual analogue scale was lower for the placebo group compared to the pledget group immediately (2.51 cm vs. 2.8 cm), 10-minutes (1.81 cm vs. 2.13 cm) and 20-minutes (1.23 cm vs. 1.65 cm) after injection, however this was not statistically significant (p = 0.48, p = 0.43, p = 0.24 respectively). However, in a subgroup of treatment naïve patients, the addition of pledget anesthesia may lower pain and make IVI more tolerable.
Additional pledget soaked with proparacaine does not enhance anesthesia compared to solely using topical proparacaine for IVI, except in a subset of treatment naïve patients.
评估在接受玻璃体内注射（IVI）的患者中，棉片麻醉对以滴剂形式应用的局部丙美卡因的潜在辅助作用。
这是一项单中心、前瞻性、随机、双盲交叉研究。纳入60例患者。接受IVI的患者先给予0.5%丙美卡因滴眼液，然后按1:1比例随机分为两组，分别接受浸泡有0.5%丙美卡因的棉片或浸泡有生理盐水的棉片作为安慰剂。患者随后交叉接受另一种干预措施。注射后立即、10分钟和20分钟时，用视觉模拟量表（VAS）和问卷评估疼痛程度。
注射后立即（2.51厘米对2.8厘米）、10分钟（1.81厘米对2.13厘米）和20分钟（1.23厘米对1.65厘米）时，安慰剂组在视觉模拟量表上评估的疼痛强度低于棉片组，但差异无统计学意义（分别为p = 0.48、p = 0.43、p = 0.24）。然而，在未接受过治疗的患者亚组中，添加棉片麻醉可能会减轻疼痛，使IVI更易于耐受。
与仅使用局部丙美卡因进行IVI相比，额外使用浸泡有丙美卡因的棉片并不能增强麻醉效果，除了在未接受过治疗的患者亚组中。
