Prevalence of opioid usage with monitored anesthesia care in cataract surgery: single-site review

Jackson, Kevin; Kim, Terry

doi:10.1097/j.jcrs.0000000000001238

Cited by 1 publication

(1 citation statement)

References 6 publications

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“… 25 Another retrospective analysis of 3,764 routine cataract surgeries performed by 33 surgeons at Duke University found that 97% of cases received IV fentanyl during surgery on top of topical tetracaine 0.5% solution. 26 Zakrewski et al, evaluated 1957 routine cataract surgeries in Canada and found that 83.1% of patients received fentanyl for the procedure. 27 …”

Section: Discussionmentioning

confidence: 99%

Chloroprocaine 3% Gel as a Novel Ocular Topical Anesthetic: Results from a Multicenter, Randomized Clinical Trial in Patients Undergoing Cataract Surgery

Figus,

Giansanti,

Villani

et al. 2024

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To compare the efficacy and safety of a novel ophthalmic anesthetic, chloroprocaine 3% gel to tetracaine 0.5% eye drops in patients undergoing cataract surgery with phacoemulsification. Methods: This was a prospective, randomized, multicenter, active-controlled, masked-observer, parallel group competitive equivalence study. The study comprised 338 patients having routine cataract extraction by clear corneal phacoemulsification, randomized to receive 3 drops of chloroprocaine gel ( n = 166) or tetracaine eye drops ( n = 172) before surgery. The primary objective of the study was to assess the equivalence of chloroprocaine gel to tetracaine eye drops as proportion of patients with successful ocular surface anesthesia, without any supplementation just before intraocular lens implantation. Safety measurements were pain, irritation, burning, stinging, photophobia, and foreign body sensation, graded by the patient and objective ocular signs. Results: Equivalence was demonstrated, with a somewhat higher success rate of chloroprocaine gel: 152/166 (92.0%) chloroprocaine versus 153/172 (90.5%) tetracaine patients achieved ocular surface anesthesia with no supplementation. Difference in proportions was 1.5% confidence interval [95% CI: (−3.6 to 6.6)] and 90% CI fell within (−10 to 10). Mean onset of anesthesia was 1.35 ± 0.87 min for chloroprocaine and 1.57 ± 1.85 for tetracaine ( P = 0.083). Mean duration of anesthesia was 21.57 ± 12.26 min for chloroprocaine and 22.04 ± 12.58 for tetracaine ( P = 0.574). No treatment emergent adverse events related to chloroprocaine were reported and no relevant findings related to local tolerance or vital signs were observed in both arms. Conclusions: Results obtained from the present cataract study demonstrated that chloroprocaine 3% ophthalmic gel is safe and effective, representing a valid alternative in ocular topical anesthesia. Clinical Trial Registration number: NCT04685538.

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Section: Discussionmentioning

confidence: 99%