felypressin and proxymetacaine

We present a new local anesthetic technique for ophthalmic surgery that reduces the risks associated with retrobulbar and peribulbar anesthesia. This method uses topical proparacaine plus 1.5 mL of prilocaine (3%) with felypressin injected into the subconjunctival (sub-Tenon's) space. Of 5210 consecutive adult patients in whom the technique was used, all demonstrated adequate analgesia. Sixty-three (1.2%) of the eyes required supplemental analgesia, provided by a single injection of prilocaine (0.5 mL). Ecchymosis and subconjunctival hemorrhage developed in 63 (1.2%) of the eyes. There were no instances of ptosis.

Topics: Adult; Aged; Analgesia; Anesthesia, Local; Anesthetics, Local; Conjunctiva; Eye Diseases; Eye Movements; Felypressin; Humans; Injections; Middle Aged; Prilocaine; Propoxycaine