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- W2037421121 abstract "Abstract Objective To evaluate the effectiveness of topical anesthesia with cocaine versus lidocaine plus adrenaline for outpatient transcanalicular and endonasal dacryocystorhinostomy (TCLDCR) with diode laser under sedation. Methods A double blind randomized clinical trial was designed using topical anesthesia for outpatient TCLDCR in the treatment of adult epiphora. A total of 92 patients were enrolled, and randomly allocated to be operated on under sedation and topical anesthesia with cocaine 4% pledgets versus sedation and topical anesthesia with lidocaine 2% plus 1/100.000 adrenaline pledgets. Main outcome measures were postoperative comfort, evaluated by a visual analog scale, presence of secondary effects (blood pressure, heart rate), and resolution of epiphora, evaluated by Munk's scale and endoscopic control. Results Patients in both groups reported being comfortable during and immediately after TCLDCR. Visualization of the operative field was adequate, and surgery was successfully completed in all cases. Complications were more common in the cocaine group: sixteen patients from the cocaine group had high blood pressures, versus 2 patients from the lidocaine group (RR = 8). Mean blood loss was 6.09 ml in cocaine group, versus 2.05 ml in lidocaine group (RR = 6). Both parameters were statistically significant (p = 1.1 × 10−9). There were no cases of postoperative epistaxis requiring nasal packing or hospital admission in any group. Success rate was similar in the 2 groups (86.96% group 1 and 89.13% group 2), after 6 months of follow-up. Conclusions The combination of topical lidocaine and adrenaline is more effective for outpatient transcanalicular and endonasal dacryocystorhinostomy than topical cocaine. Patient comfort was adequate in both groups, but high blood pressure and blood loss more common after cocaine." @default.
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- W2037421121 date "2014-02-01" @default.
- W2037421121 modified "2023-09-27" @default.
- W2037421121 title "Comparison between topical anesthesia with cocaine versus lidocaine plus adrenaline for outpatient laser dacryocystorhinostomy" @default.
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- W2037421121 doi "https://doi.org/10.1016/j.oftale.2014.04.013" @default.
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