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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
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Randomised Controlled Trial: Influence of Subconjunctival Anaesthesia Duration on Pain Perception During Intravitreal

Jiyeon Kim1, Louis S Han1, Logan Robinson1

  • 1Ophthalmology, Christchurch Hospital, Christchurch, New Zealand.

Clinical & Experimental Ophthalmology
|July 2, 2025
PubMed
Summary

A minimum 3-minute wait after subconjunctival anesthesia (SCA) for intravitreal injections (IVI) significantly reduces pain and increases patient willingness for future procedures. This wait time balances effective pain management with clinical efficiency.

Keywords:
diabetic retinopathyintravitreal injectionmacular degenerationpainsubconjunctival anaesthesia

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Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Clinical Trials

Background:

  • Intravitreal injection (IVI) is a common ophthalmic procedure.
  • Subconjunctival anesthesia (SCA) with lidocaine is used to manage pain during IVI.
  • Optimal wait time between SCA and IVI is not established.

Purpose of the Study:

  • To determine the optimal wait time between subconjunctival anesthesia (SCA) and intravitreal injection (IVI).
  • To balance effective pain reduction with clinical efficiency.

Main Methods:

  • Single-blinded randomized clinical trial involving 240 patients.
  • Patients were assigned to 2, 3, 4, or 5-minute wait times post-SCA.
  • Primary outcome: pain level (visual analogue scale); Secondary outcome: willingness for future IVI.

Main Results:

  • Mean pain scores decreased with longer wait times (2.27 at 2 min to 0.58 at 5 min).
  • Patient willingness for repeat IVI increased with wait time (92% at 2 min to 100% at 5 min).
  • Statistically significant differences observed at each interval.

Conclusions:

  • Longer wait times post-SCA improve anesthetic effect and patient acceptance of IVI.
  • A minimum 3-minute wait is recommended, offering low pain scores (1.03) and high patient satisfaction (97%).
  • The most significant improvement in pain and acceptance was noted between 2- and 3-minute wait times.