Gelatt KN, Mackay EO. Prevalence of primary breed-related cataracts in the dog in North America. Vet Ophthalmol 2005;8:101–111.
Petersen-Jones S. The lens. In: Petersen-Jones S, Crispin S, eds. BSAVA manual of small animal ophthalmology. 2nd ed. Gloucester, England: British Small Animal Veterinary Association, 2002;204–218.
Smith LJ, Bentley E, Shih A, et al. Systemic lidocaine infusion as an analgesic for intraocular surgery in dogs: a pilot study. Vet Anaesth Analg 2004;31:53–63.
Muir WW. Physiology and pathophysiology of pain. In: Gaynor JS, Muir WW, eds. Handbook of veterinary pain management. St Louis: Mosby, 2002;13–45.
Kaswan RL, Quandt JE, Moore PA. Narcotics, miosis, and cataract surgery (lett). J Am Vet Med Assoc 1992;201:1819–1820.
Boothe DM. Anti-inflammatory drugs. In: Boothe DM, ed. Small animal clinical pharmacology and therapeutics. Philadelphia: Saunders, 2001;281–311.
Giuliano EA. Nonsteroidal anti-inflammatory drugs in veterinary ophthalmology. Vet Clin North Am Small Anim Pract 2004;34:707–723.
Lin JC, Rapuano CJ, Laibson PR, et al. Corneal melting associated with use of topical nonsteroidal anti-inflammatory drugs after ocular surgery. Arch Ophthalmol 2000;118:1129–1132.
Shimazaki J, Saito H, Yang HY, et al. Persistent epithelial defect following penetrating keratoplasty: an adverse effect of diclofenac eyedrops. Cornea 1995;14:623–627.
Hendrix DV, Ward DA, Barnhill MA. Effects of anti-inflammatory drugs and preservatives on morphologic characteristics and migration of canine corneal epithelial cells in tissue culture. Vet Ophthalmol 2002;5:127–135.
Wilkie DA. Control of ocular inflammation. Vet Clin North Am Small Anim Pract 1990;20:693–713.
Millichamp NJ, Dziezyc J, Olsen JW. Effect of flurbiprofen on facility of aqueous outflow in the eyes of dogs. Am J Vet Res 1991;52:1448–1451.
Skarda RT, Tranquilli WJ. Local anesthetics. In: Tranquilli WJ, Thurmon JC, Grimm KA, eds. Lumb & Jones' veterinary anesthesia and analgesia. 4th ed. Ames, Iowa: Blackwell Publishing, 2007;395–418.
Chabal C, Russell LC, Burchiel KJ. The effect of intravenous lidocaine, tocainide, and mexiletine on spontaneously active fibers originating in rat sciatic neuromas. Pain 1989;38:333–338.
Plumb DC. Lidocaine HCL. In: Plumb DC, ed. Plumb's veterinary drug handbook. 5th ed. Ames, Iowa: Blackwell Publishing, 2004;661–664.
Crandall AS, Zabriskie NA, Patel BC, et al. A comparison of patient comfort during cataract surgery with topical anesthesia versus topical anesthesia and intracameral lidocaine. Ophthalmology 1999;106:60–66.
Naor J, Slomovic AR. Anesthesia modalities for cataract surgery. Curr Opin Ophthalmol 2000;11:7–11.
Tseng SH, Chen FK. A randomized clinical trial of combined topical-intracameral anesthesia in cataract surgery. Ophthalmology 1998;105:2007–2011.
Chuang LH, Yeung L, Ku WC, et al. Safety and efficacy of topical anesthesia combined with a lower concentration of intracameral lidocaine in phacoemulsification: paired human eye study. J Cataract Refract Surg 2007;33:293–296.
Ezra DG, Nambiar A, Allan BD. Supplementary intracameral lidocaine for phacoemulsification under topical anesthesia. A meta-analysis of randomized controlled trials. Ophthalmology 2008;115:455–487.
Anderson NJ, Woods WD, Kim T, et al. Intracameral anesthesia: in vitro iris and corneal uptake and washout of 1% lidocaine hydrochloride. Arch Ophthalmol 1999;117:225–232.
Gerding PA Jr, Turner TL, Hamor RE, et al. Effects of intracameral injection of preservative-free lidocaine on the anterior segment of the eyes in dogs. Am J Vet Res 2004;65:1325–1330.
Park SA, Kim NR, Park YW, et al. Evaluation of the mydriatic effect of intracameral lidocaine hydrochloride injection in eyes of clinically normal dogs. Am J Vet Res 2009;70:1521–1525.
Carino NS, Slomovic AR, Chung F, et al. Topical tetracaine versus topical tetracaine plus intracameral lidocaine for cataract surgery. J Cataract Refract Surg 1998;24:1602–1608.
Hall LW, Clarke KW, Trim CM. Patient monitoring and clinical measurement. In: Veterinary anaesthesia. 10th ed. London: WB Saunders Co, 2001;29–59.
Novello L, Corletto F, Rabozzi R, et al. Sparing effect of a low dose of intrathecal morphine on fentanyl requirements during spinal surgery: a preliminary clinical investigation in dogs. Vet Surg 2008;37:153–160.
Hellyer PW. Objective, categoric methods for assessing pain and analgesia. In: Gaynor JS, Muir WW III, eds. Handbook of veterinary pain management. St Louis: Mosby, 2002;82–107.
Leibetseder EN, Mosing M, Jones RS. A comparison of extradural and intravenous methadone on intraoperative isoflurane and postoperative analgesia requirements in dogs. Vet Anaesth Analg 2006;33:128–136.
Iradier MT, Fernandez C, Bohorquez P, et al. Intraocular lidocaine in phacoemulsification: an endothelium and blood-aqueous barrier permeability study. Ophthalmology 2000;107:896–900.
Eggeling P, Pleyer U, Hartmann C, et al. Corneal endothelial toxicity of different lidocaine concentrations. J Cataract Refract Surg 2000;26:1403–1408.
Liou SW, Chiu CJ, Wang IJ. Effect of intracameral injection of lidocaine and carbachol on the rabbit corneal endothelium. J Cataract Refract Surg 2004;30:1351–1355.
Lincoff H, Zweifach P, Brodie S, et al. Intraocular injection of lidocaine. Ophthalmology 1985;92:1587–1591.
Hoffman RS, Fine IH. Transient no light perception visual acuity after intracameral lidocaine injection. J Cataract Refract Surg 1997;23:957–958.
Liang C, Peyman GA, Sun G. Toxicity of intraocular lidocaine and bupivacaine. Am J Ophthalmol 1998;125:191–196.
Anders N, Heuermann T, Ruther K, et al. Clinical and electrophysiologic results after intracameral lidocaine 1% anesthesia: a prospective randomized study. Ophthalmology 1999;106:1863–1868.
Lou L, Sabar R, Kaye AD. Drugs used in regional anesthesia (A). In: Raj PP, ed. Textbook of regional anesthesia. New York: Elsevier Science, 2002;177–213.
Nunes de Moraes A, Dyson DH, O'Grady MR, et al. Plasma concentrations and cardiovascular influence of lidocaine infusions during isoflurane anesthesia in healthy dogs and dogs with subaortic stenosis. Vet Surg 1998;27:486–497.
Wirbelauer C, Iven H, Bastian C, et al. Systemic levels of lidocaine after intracameral injection during cataract surgery. J Cataract Refract Surg 1999;25:648–651.
Nikeghbali A, Falavarjani KG, Kheirkhah A, et al. Pupil dilation with intracameral lidocaine during phacoemulsification. J Cataract Refract Surg 2007;33:101–103.
Ozkurt Y. Intraoperative lidocaine in phacoemulsification without preoperative eyedrops (lett). J Cataract Refract Surg 2006;32:178.
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Objective—To evaluate the intraoperative and postoperative analgesic effects of intracameral lidocaine hydrochloride injection in dogs undergoing phacoemulsification.
Animals—12 healthy Beagles with healthy eyes.
Procedures—Dogs were randomly assigned to receive 1 of 2 intracameral injections: 2% lidocaine hydrochloride solution (0.3 mL) or an equivalent amount of balanced salt solution (BSS). All dogs were treated with acepromazine (0.05 mg/kg, IV) and cefazolin (30 mg/kg, IV), and tropicamide drops were topically applied to the eyes. Anesthesia was induced with propofol and maintained with isoflurane. The initial end-tidal isoflurane concentration was maintained at 1.2%. Heart rate, respiratory rate, arterial blood pressure, esophageal temperature, inspired and end-tidal isoflurane concentrations, and oxygen saturation were recorded every 5 minutes. The allocated agent was injected intracamerally after aspiration of the same volume of aqueous humor. Ten minutes after injection, phacoemulsification was performed. After surgery began, the isoflurane concentration was adjusted according to heart rate and mean arterial blood pressure. Pain scores were recorded before surgery and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 6, 8, 16, and 24 hours after extubation.
Results—Isoflurane requirements were significantly higher in the BSS group than in the lidocaine group. Mean ± SD time to administration of supplementary analgesia was significantly shorter in the BSS group (1.4 ± 1.2 hours) than in the lidocaine group (4.9 ± 1.2 hours).
Conclusions and Clinical Relevance—Intracameral lidocaine injection had significant analgesic effects in dogs undergoing cataract surgery. Results of this study suggest the value of intracameral lidocaine injection as an analgesic for intraocular surgery in dogs.
Supported by the BK21 Program for Veterinary Science and the Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University.