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Dias PB, Rodrigues Parchen MDA, Wasilewski D. Comparison of Proparacaine, Tetracaine, and Oxybuprocaine in Corneal Sensitivity Measurement. J Ocul Pharmacol Ther 2024; 40:215-221. [PMID: 38597912 DOI: 10.1089/jop.2023.0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Purpose: This study aimed to determine the onset and duration of action of 3 commercially available topical anesthetic solutions in Brazil, using the Cochet-Bonnet esthesiometer (Luneau®, Paris, France) and to quantitatively assess patient-reported discomfort during application. Methods: A prospective, randomized, masked, and double-blind study was conducted, involving 40 eyes from 21 patients. Patients were administered each one of the topical anesthetics weekly, and corneal sensitivity was measured using the Cochet-Bonnet esthesiometer's corneal touch threshold (CTT). Patients rated the burning sensation using a visual analogue scale (VAS). Results: Among the 21 patients (42.9% male), with a mean age of 31.95 years (±standard deviation = 10.17, range = 22.0-58.0), corneal sensitivity significantly decreased 30 s after application, returning to baseline after 30 min for all groups (P < 0.0001). Significant differences in CTT were observed at 5 min, with proparacaine exhibiting a superior anesthetic effect (P = 0.0003), at 10 min, where tetracaine displayed the most substantial anesthetic effect (P = 0.0135), and at 20 min, where tetracaine demonstrated the highest anesthetic efficacy (P < 0.0001). VAS scores indicated the most intense burning sensation with tetracaine (P < 0.0001). Men reported experiencing more discomfort during instillation compared with women (P = 0.0168). Conclusions: Proparacaine exhibited the fastest onset of action among the 3 topical anesthetics and provided a more comfortable eye sensation during instillation. However, tetracaine demonstrated the longest duration of action despite causing more discomfort.
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Affiliation(s)
- Paula Basso Dias
- Department of Ophthalmology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | | | - Daniel Wasilewski
- Department of Ophthalmology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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Gonzalez GA, Betbeze C, Wills R, Eddy A, Mochal-King C, Fontenot RL. Effects of subconjunctival ropivacaine, liposomal bupivacaine, and mepivacaine on corneal sensitivity in healthy horses. Vet Surg 2023; 52:1041-1049. [PMID: 37332132 DOI: 10.1111/vsu.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/08/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To evaluate corneal sensitivity and adverse events following subconjunctival administration of three local anesthetics in horses. STUDY DESIGN Randomized, masked, crossover study. ANIMALS Twelve healthy adult mares. METHODS The subconjunctival space of the treated eye was injected with 0.2 mL of liposomal bupivacaine (1.3%), ropivacaine (0.5%), or mepivacaine (2%). All horses received each medication once and the contralateral eye received saline (control). Corneal touch threshold (CTT) was measured using a Cochet-Bonnet esthesiometer before sedation, after sedation, and at specified intervals until it returned to baseline. Ocular examinations were performed at 24-, 72, and 168 h post-injection to monitor for adverse effects. RESULTS The mean total time of anesthesia (TTA) was 168.3 min for ropivacaine, 169.2 min for liposomal bupivacaine, 103.3 min for mepivacaine and 30.7 min for the control. TTA for liposomal bupivacaine (p < .001) and ropivacaine (p = .001) was longer than the control. TTA for mepivacaine was not different from the control (p = .138), liposomal bupivacaine (p = .075) or ropivacaine (p = .150). Injection site hemorrhage reduced TTA regardless of treatments (p = .047). No adverse effects attributed to injections were noted. CONCLUSION All three medications were well tolerated. Subconjunctival administration of ropivacaine and liposomal bupivacaine resulted in longer TTAs compared to the control; however, their TTAs were not different from that of mepivacaine. CLINICAL SIGNIFICANCE Subconjunctivally administered liposomal bupivacaine and ropivacaine are viable options to provide prolonged corneal analgesia in horses. Future studies are needed to assess the efficacy in diseased eyes.
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Affiliation(s)
- Gabriel A Gonzalez
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Caroline Betbeze
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Robert Wills
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Alison Eddy
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Cathleen Mochal-King
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Robin L Fontenot
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
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Minaldi MP, Fidler LE, Betbeze CM, Wills R, Fontenot RL, Telle MR. Topical ropivacaine hydrochloride 0.5% and lidocaine hydrochloride 2% significantly reduce corneal sensitivity without short-term negative side effects in horses. Vet Ophthalmol 2023; 26:446-451. [PMID: 37548143 DOI: 10.1111/vop.13137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/08/2023] [Accepted: 07/19/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE To evaluate corneal sensitivity and acute side effects following application of ropivacaine hydrochloride 0.5% and lidocaine hydrochloride 2% on the healthy equine cornea. ANIMALS STUDIED Eight healthy adult horses. PROCEDURE A randomized, masked, crossover study design was utilized. Baseline Semiquantitative Preclinical Ocular Toxicology (SPOT) scores and corneal touch thresholds (CTT) using a Cochet-Bonnet esthesiometer were recorded and measured, respectively, for eight healthy adult horses before medication application. Commercially available eyewash was used as a negative control. Ropivacaine hydrochloride 0.5% or lidocaine hydrochloride 2% solution was sprayed on a randomly selected eye, and the contralateral eye received eyewash. CTT was measured in both eyes at 1, 5, 15, 25, 35, 45, 55, 65, and 75 min post-application. Post-application SPOT scores were recorded immediately following the trial. Linear mixed model statistical analyses (mean ± standard error) were performed (p < .05). RESULTS Mean eyewash CTT (3.41 cm ± 0.464) was significantly different from ropivacaine-treated (1.44 cm ± 0.562) (p = .008) and lidocaine-treated eyes (1.75 cm ± 0.562) (p = .024); CTT was not significantly different between drug groups (p = .88). Time to maximum anesthesia was not significantly different between ropivacaine (13.25 min ± 3.353) and lidocaine (16.25 min ± 3.353) (p = .40). No side effects were appreciated as confirmed by SPOT. CONCLUSIONS Ropivacaine and lidocaine similarly decreased corneal sensitivity when applied topically without clinically evident short-term ocular side effects. Lidocaine may be preferable in clinical settings due to its large, multi-use vials and similar effects to ropivacaine.
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Affiliation(s)
- Michael P Minaldi
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Laura E Fidler
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Caroline M Betbeze
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Robert Wills
- College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Robin L Fontenot
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Mary R Telle
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
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4
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Makra Z, Eördögh R, Fábián I, Veres-Nyéki K. Evaluation of corneal anaesthesia after the application of topical 0.5% bupivacaine, 2% lidocaine and 0.4% oxybuprocaine in normal horses. Vet Anaesth Analg 2021; 48:972-976. [PMID: 34538596 DOI: 10.1016/j.vaa.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 03/09/2021] [Accepted: 04/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To compare the corneal anaesthetic effect of 0.5% bupivacaine, 2% lidocaine and 0.4% oxybuprocaine on normal equine eyes. STUDY DESIGN Prospective, blinded crossover study. ANIMALS A group of 10 clinically healthy horses. METHODS Corneal sensitivity was determined in each eye by measuring corneal touch threshold (CTT). The study had three phases. Each subject was randomly given one of the three treatments followed by a 72 hour washout period. Every horse received all treatments. Baseline CTT was recorded prior to anaesthetic instillation (T0) then CTT was measured 5 and 10 minutes after (T1 and T2, respectively), then 20 to 90 minutes (T3 to T10) at 10 minute intervals. CTT data were compared among treatments at each time point using the Friedman test p < 0.05. RESULTS Median (range) baseline CTT was 51.3 (25.0-60.0) mm for bupivacaine, 50.0 (40.0-55.0) mm for oxybuprocaine and 55.0 (30.0-60.0) mm for lidocaine. All treatments caused a significant decrease in CTT at T1. The lowest CTT was observed at T3 with bupivacaine and oxybuprocaine treatments. Median CTTs at this time point were 18.7 (5.0-25.0) mm and 28.7 (25.0-40.0) mm, respectively. The lowest CTT with lidocaine treatment was 28.7 (20.0-50.0) mm at T6 (50 minutes). At T3, CTT was significantly lower with the bupivacaine treatment compared with oxybuprocaine and lidocaine treatments (p < 0.0074). There was no significant difference in CTT values between T1 and T6 for bupivacaine, between T1 and T7 for lidocaine, and between T1 and T8 for oxybuprocaine. Duration of the maximum effect was 45 minutes for the bupivacaine, 55 minutes for the lidocaine and 65 minutes for the oxybuprocaine treatment. CONCLUSIONS AND CLINICAL RELEVANCE Administration of a 0.5% injectable solution of bupivacaine or a 2% lidocaine had similar anaesthetic effect to the commonly used oxybuprocaine. Therefore, they might be used as alternatives for corneal anaesthesia.
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Affiliation(s)
- Zita Makra
- Department and Clinic of Equine Medicine, University of Veterinary Medicine, Budapest, Hungary.
| | - Réka Eördögh
- Állatszemész, University of Veterinary Medicine, Budapest, Hungary
| | - Ibolya Fábián
- Department of Biomathematics and Informatics, University of Veterinary Medicine, Budapest, Hungary
| | - Kata Veres-Nyéki
- Royal Veterinary College, Anaesthesia and Analgesia Service, London, UK
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Kyei S, Abaka Dadzie NY, Zaabaar E, Asamoah Dwomoh KA, Asiedu K. Age and Sex Variation in the Duration of Action and Corneal Touch Threshold (CTT) following Instillation of 0.5% Topical Ophthalmic Proparacaine and Tetracaine Hydrochlorides. J Ophthalmol 2021; 2021:8661098. [PMID: 34336260 PMCID: PMC8294970 DOI: 10.1155/2021/8661098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/09/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We investigated the effect of age and sex on corneal touch threshold (CTT) and duration of action following administration of 0.5% topical ophthalmic proparacaine and tetracaine hydrochlorides. METHODS A prospective, randomized, subject-masked, crossover study design was used. Two hundred and forty human volunteers were enrolled in the study. Corneal touch threshold (CTT) was determined using a Cochet-Bonnet esthesiometer. CTT was measured every 15 seconds for the first 1-minute and at 5-minute intervals subsequently for a period of 40 minutes after the application of each anesthetic. CTT and duration of action of the ophthalmic solutions were tested for statistical significance using repeated measures ANOVA. RESULTS The total duration of effect was 20 minutes for females and 25 minutes for males for both anesthetics. The total duration of the effect of both solutions decreased with increasing age; however, elderly participants had the longest duration (5 minutes) of the maximal effect (minimum CTT) of the two ophthalmic preparations. There was a significant influence of sex, F (2.39, 569.65) = 2.86, p=0.04; F (3.48, 828.19) = 4.41, p=0.003, and age, F (4.78, 566.18) = 8.97, p < 0.001; F (7.19, 852.56) = 20.55, p < 0.001 on CTT following application of proparacaine hydrochloride and tetracaine hydrochloride, respectively. CONCLUSION CTT and duration of anesthetic effect after instillation of 1 drop of 0.5% proparacaine hydrochloride and 0.5% tetracaine hydrochloride vary based on sex and age.
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Affiliation(s)
- Samuel Kyei
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Ebenezer Zaabaar
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Kwasi Antwi Asamoah Dwomoh
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Kofi Asiedu
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Effect of four local anesthetics (tetracaine, proparacaine, lidocaine, and bupivacaine) on intraocular pressure in dogs. Int Ophthalmol 2018; 39:1467-1474. [PMID: 29934932 DOI: 10.1007/s10792-018-0969-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To measure IOP in animals, it is often necessary to use topical anesthetics. The use of these drugs may cause changes in IOP and interfere with the final results. To address this issue, the effects of four local anesthetics (tetracaine, proparacaine, lidocaine, and bupivacaine) on IOP were investigated in ten adult dogs. METHODS One drop of tetracaine was instilled in the right eye of half of the dogs and in the left eye of the other dogs; normal saline was instilled in the fellow eyes. The IOP in each dog was measured before and at 0, 5, 10, 15, 20, 25, 30, and 35 min after drug instillation using an electronic rebound tonometer. The effects of the other anesthetics were studied in the same way at intervals of at least 1 week. RESULTS After instillation of tetracaine, the IOP decreased gradually, such that after 15 min, the IOP was significantly lower than the baseline (p = 0.022) and control values (p = 0.048). Proparacaine also reduced IOP after 10 min compared to baseline values (p = 0.046), but the two other drugs, bupivacaine and lidocaine, had no significant effect on IOP. The duration of eye anesthesia was 16, 20, 22, and 34 min for tetracaine, lidocaine, bupivacaine, and proparacaine, respectively. CONCLUSION We recommend using drugs that combine inducing longer anesthesia with producing the smallest change in IOP, such as bupivacaine and, subsequently, lidocaine. Tetracaine and proparacaine have a significant effect on IOP, and if these drugs are used, this effect should be considered.
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Telle MR, Chen N, Shinsako D, Kiland JA, Oikawa K, Møller Trane R, McLellan GJ. Relationship between corneal sensitivity, corneal thickness, corneal diameter, and intraocular pressure in normal cats and cats with congenital glaucoma. Vet Ophthalmol 2018. [PMID: 29517120 DOI: 10.1111/vop.12558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the effect of feline congenital glaucoma (FCG) on corneal sensitivity, and relationships between corneal sensitivity, central corneal thickness (CT), and corneal diameter (CD). ANIMALS AND PROCEDURES Corneal sensitivity (estimated by corneal touch threshold [CTT] using Cochet-Bonnet esthesiometry); CT using ultrasonic pachymetry; intraocular pressure (IOP) using rebound tonometry; and maximal horizontal CD were measured in 16 normal and 14 FCG cats, both males and females, aged 7 months-3.5 years. All procedures complied with an Institutional Animal Care and Use Committee-approved protocol. Data were analyzed by linear regression: paired Student's t tests for between-eye comparisons, and unpaired Student's t tests for comparisons between groups. Relationships between parameters were evaluated by Pearson correlation coefficients and linear mixed effects modeling. For statistical tests, with the exception of values that were Benjamini-Hochberg adjusted for multiple comparisons, P-values < 0.05 were considered significant. RESULTS Mean CTT and CT values were lower in FCG eyes relative to normal eyes, but differences were not statistically significant. Mean CD was significantly larger in FCG eyes relative to normal eyes, and there was a significant negative correlation between CD and CTT in FCG (r = -0.8564, corrected P = 0.005). These associations were confirmed in linear mixed effects models. CONCLUSIONS Eyes with FCG have significantly larger CDs when compared with normal eyes, and larger CDs correlated with decreased corneal sensitivity in this group. Further studies are warranted to explore the effect of buphthalmos and corneal enlargement on corneal sensitivity and innervation in feline subjects with chronic glaucoma.
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Affiliation(s)
- Mary R Telle
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Nickolas Chen
- Department of Ophthalmology & Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Daniel Shinsako
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.,Department of Ophthalmology & Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Julie A Kiland
- Department of Ophthalmology & Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Kazuya Oikawa
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.,Department of Ophthalmology & Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.,McPherson Eye Research Institute, University of Wisconsin, Madison, WI, USA
| | - Ralph Møller Trane
- Department of Ophthalmology & Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Gillian J McLellan
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.,Department of Ophthalmology & Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.,McPherson Eye Research Institute, University of Wisconsin, Madison, WI, USA
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8
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Regnier A, Berton I, Concordet D, Douet JY. Effect of topical application of 2% lidocaine gel on corneal sensitivity of clinically normal equine eyes. Vet Anaesth Analg 2018; 45:158-164. [DOI: 10.1016/j.vaa.2017.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 08/14/2017] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
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Jinks MR, Fontenot RL, Wills RW, Betbeze CM. The effects of subconjunctival bupivacaine, lidocaine, and mepivacaine on corneal sensitivity in healthy horses. Vet Ophthalmol 2017; 21:498-506. [PMID: 29232029 DOI: 10.1111/vop.12537] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To compare the efficacy and duration of effect of three local anesthetics on corneal sensitivity when administered subconjunctivally in horses. ANIMALS STUDIED Eight healthy adult horses. PROCEDURE A randomized, masked, crossover study design was used, with a two-week washout period between trials. The subconjunctival space of the randomly selected eye was injected with 0.2 mLs of bupivacaine (0.5%), lidocaine (2%), mepivacaine (2%), or saline. All horses received each medication once. The contralateral eye served as a control. The corneal touch threshold (CTT) was measured in both eyes with a Cochet-Bonnet esthesiometer prior to sedation with xylazine, after sedation, and at 10-min intervals after subconjunctival injection until corneal sensitivity returned to baseline. The total time of decreased CTT and the maximum decrease in CTT were compared for each medication using a general linear mixed model (P < 0.05). RESULTS Total time of decreased CTT was 105.0 min for bupivacaine, 103.8 min for lidocaine, 138.8 min for mepivacaine, and 7.5 min for saline. All local anesthetics decreased CTT longer than saline (P < 0.001) and mepivacaine decreased CTT longer than lidocaine (P = 0.04). The mean minimum CTT was 1.67 cm for bupivacaine, 1.42 cm for lidocaine, and 0.73 cm for mepivacaine, which were all significantly less (P < 0.001) than saline (4.73 cm). No evidence of corneal toxicity was noted with any treatment. CONCLUSION Subconjunctival injections of lidocaine, bupivacaine, and mepivacaine effectively and safely reduce corneal sensitivity in eyes of healthy horses for 1.5-2 h, and may be useful for providing perioperative analgesia for equine corneal procedures.
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Affiliation(s)
- Maggie R Jinks
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - Robin L Fontenot
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - Robert W Wills
- Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - Caroline M Betbeze
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
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10
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Gordon E, Sandquist C, Cebra CK, Heidel J, Poulsen K, Schlipf JW. Esthesiometric evaluation of corneal analgesia after topical application of 1% morphine sulfate in normal horses. Vet Ophthalmol 2017; 21:218-223. [DOI: 10.1111/vop.12494] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Emma Gordon
- Department of Clinical Sciences; College of Veterinary Medicine; Oregon State University; 158 Magruder Hall Corvallis OR USA
| | - Christy Sandquist
- Department of Clinical Sciences; College of Veterinary Medicine; Oregon State University; 158 Magruder Hall Corvallis OR USA
| | - Christopher K. Cebra
- Department of Clinical Sciences; College of Veterinary Medicine; Oregon State University; 158 Magruder Hall Corvallis OR USA
| | - Jerry Heidel
- Department of Biomedical Sciences; College of Veterinary Medicine; Oregon State University; Corvallis OR USA
| | - Keith Poulsen
- Department of Medical Sciences; School of Veterinary Medicine and Wisconsin Veterinary Diagnostic Laboratory; University of Wisconsin-Madison; Madison WI USA
| | - John W. Schlipf
- Department of Clinical Sciences; College of Veterinary Medicine; Oregon State University; 158 Magruder Hall Corvallis OR USA
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11
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Knickelbein KE, Scherrer NM, Lassaline M. Corneal sensitivity and tear production in 108 horses with ocular disease. Vet Ophthalmol 2017; 21:76-81. [DOI: 10.1111/vop.12481] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kelly E. Knickelbein
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Nicole M. Scherrer
- New Bolton Center; School of Veterinary Medicine; University of Pennsylvania; Kennett Square PA USA
| | - Mary Lassaline
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
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12
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Trbolova A, Ghaffari MS. Results of the Schirmer tear test performed with open and closed eyes in clinically normal horses. Acta Vet Scand 2017; 59:35. [PMID: 28569172 PMCID: PMC5452394 DOI: 10.1186/s13028-017-0303-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 05/21/2017] [Indexed: 11/30/2022] Open
Abstract
Background The Schirmer tear test (STT) is widely used in both human and veterinary ophthalmology. Two types of STTs have been developed: STT I and SST II. The STT I measures the basal and reflex tear production and is the most widely used STT. However, several factors influence the STT results such as the person performing the test and the location of the strip placement within the conjunctival sac. The aim of this study was to measure the basal and reflex tear production (STT I) in clinically normal horses with open versus closed eyes. Results Forty clinically healthy horses without any ocular diseases were included. On day 1, the STT I was first performed on all the horses with the eyes open followed by an STT I with closed eyes performed 30 min later. On day 2, all horses had their eyes closed during the first STT and the eyes open during the second test performed 30 min later. The mean value of the STTs performed on open eye was significantly less than the STT performed on closed eye on both days of examination. Conclusion This study showed a small but statistically significant difference between STT values obtained with open versus closed eyes in clinically normal horses.
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13
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Little WB, Jean GS, Sithole F, Little E, Jean KYS. Degree of corneal anaesthesia after topical application of 0.4% oxybuprocaine hydrochloride and 0.5% proparacaine hydrochloride ophthalmic solution in clinically normal cattle. Aust Vet J 2017; 94:181-5. [PMID: 27237118 DOI: 10.1111/avj.12443] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 08/10/2015] [Accepted: 09/07/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The use of corneal anaesthesia is necessary for a range of clinical purposes. Therefore, we assessed and compared the efficacy of corneal anaesthesia after application of 0.4% oxybuprocaine hydrochloride and 0.5% proparacaine hydrochloride ophthalmic solution in clinically normal cattle. METHODS The 24 clinically normal cows were allocated into two groups. Cows in group 1 (n = 12) received 0.2 mL of 0.4% oxybuprocaine hydrochloride with fluorescein ophthalmic solution in one eye and 0.2 mL of sterile saline (0.9% NaCl) with fluorescein in the contralateral eye (control). Group 2 (n = 12) received 0.2 mL of 0.4% oxybuprocaine hydrochloride with fluorescein ophthalmic solution in one eye and 0.2 mL of 0.5% proparacaine hydrochloride with fluorescein in the contralateral eye (control). In each group, corneal touch threshold was determined by Cochet-Bonnet aesthesiometer for both eyes immediately prior to topical administration of solutions, at 1 min and 5 min after administration of topical solutions and every 5 min thereafter for a total of 75 min. RESULTS Significant corneal anaesthesia was noted immediately following topical application of both oxybuprocaine and proparacaine as compared with controls, with maximal corneal anaesthesia noted 1 min after administration. Both oxybuprocaine and proparacaine produced significant corneal anaesthesia for the duration of the 75-min study. Neither oxybuprocaine hydrochloride nor proparacaine hydrochloride treatment resulted in visible adverse effects. CONCLUSION There are limited data available demonstrating the efficacy and duration of corneal anaesthetic agents in cattle. Both oxybuprocaine hydrochloride and proparacaine hydrochloride should be considered practical options for providing corneal anaesthesia in cattle in a clinical setting.
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Affiliation(s)
- W B Little
- Department of Clinical Sciences, Ross University College of Veterinary Medicine, Island Main Road, West farm, St Kitts 00265, West Indies.
| | - G St Jean
- Department of Clinical Sciences, Ross University College of Veterinary Medicine, Island Main Road, West farm, St Kitts 00265, West Indies
| | - F Sithole
- Department of Biomedical Sciences, Ross University College of Veterinary Medicine, St Kitts, West Indies
| | - E Little
- Department of Clinical Sciences, Ross University College of Veterinary Medicine, Island Main Road, West farm, St Kitts 00265, West Indies
| | - K Yvorchuk-St Jean
- Department of Clinical Sciences, Ross University College of Veterinary Medicine, Island Main Road, West farm, St Kitts 00265, West Indies
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Venturi F, Blocker T, Dees DD, Madsen R, Brinkis J. Corneal anesthetic effect and ocular tolerance of 3.5% lidocaine gel in comparison with 0.5% aqueous proparacaine and 0.5% viscous tetracaine in normal canines. Vet Ophthalmol 2016; 20:405-410. [DOI: 10.1111/vop.12440] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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McDonald JE, Knollinger AM, Dustin Dees D, MacLaren NE. Comparison of intraocular pressure measurements using rebound (TonoVet®) and applanation (TonoPen-XL®) tonometry in clinically normal alpacas (Vicugña pacos). Vet Ophthalmol 2016; 20:155-159. [DOI: 10.1111/vop.12384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - D. Dustin Dees
- Eye Care for Animals; 12419 Metric Blvd Austin TX 78758 USA
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Giudici V, Baeza S, Douet JY, Regnier A. Corneal anesthesia following application of 0.4% oxybuprocaine hydrochloride ophthalmic solution to normal feline eyes. Vet Ophthalmol 2014; 18:141-6. [DOI: 10.1111/vop.12179] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Valentina Giudici
- Département des Sciences Cliniques; INP-Ecole Nationale Vétérinaire; 23 chemin des Capelles, BP 87614 31076 Toulouse Cedex 3 France
| | - Sophia Baeza
- Département des Sciences Cliniques; INP-Ecole Nationale Vétérinaire; 23 chemin des Capelles, BP 87614 31076 Toulouse Cedex 3 France
| | - Jean-Yves Douet
- Département des Sciences Cliniques; INP-Ecole Nationale Vétérinaire; 23 chemin des Capelles, BP 87614 31076 Toulouse Cedex 3 France
| | - Alain Regnier
- Département des Sciences Cliniques; INP-Ecole Nationale Vétérinaire; 23 chemin des Capelles, BP 87614 31076 Toulouse Cedex 3 France
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Douet JY, Michel J, Regnier A. Degree and duration of corneal anesthesia after topical application of 0.4% oxybuprocaine hydrochloride ophthalmic solution in ophthalmically normal dogs. Am J Vet Res 2014; 74:1321-6. [PMID: 24066916 DOI: 10.2460/ajvr.74.10.1321] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the anesthetic efficacy and local tolerance of topically applied 0.4% oxybuprocaine ophthalmic solution to in dogs and compare its effects with those of 1% tetracaine solution. ANIMALS 34 ophthalmically normal Beagles. PROCEDURES Dogs were assigned to 2 groups, and baseline corneal touch threshold (CTT) was measured bilaterally with a Cochet-Bonnet aesthesiometer. Dogs of group 1 (n = 22) received a single drop of 0.4% oxybuprocaine ophthalmic solution in one eye and saline (0.9% NaCl) solution (control treatment) in the contralateral eye. Dogs of group 2 (n = 12) received a single drop of 0.4% oxybuprocaine ophthalmic solution in one eye and 1% tetracaine ophthalmic solution in the contralateral eye. The CTT of each eye was measured 1 and 5 minutes after topical application and then at 5-minute intervals until 75 minutes after topical application. RESULTS CTT changes over time differed significantly between oxybuprocaine-treated and control eyes. After instillation of oxybuprocaine, maximal corneal anesthesia (CTT = 0) was achieved within 1 minute, and CTT was significantly decreased from 1 to 45 minutes, compared with the baseline value. No significant difference in onset, depth, and duration of corneal anesthesia was found between oxybuprocaine-treated and tetracaine-treated eyes. Conjunctival hyperemia and chemosis were detected more frequently in tetracaine-treated eyes than in oxybuprocaine-treated eyes. CONCLUSIONS AND CLINICAL RELEVANCE Topical application of oxybuprocaine and tetracaine similarly reduced corneal sensitivity in dogs, but oxybuprocaine was less irritating to the conjunctiva than was tetracaine.
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Affiliation(s)
- Jean-Yves Douet
- Département des sciences cliniques, INP-Ecole nationale vétérinaire, 31076 Toulouse Cedex 3, France
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18
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Costa D, Peña MT, Ríos J, Leiva M. Evaluation of corneal anaesthesia after the application of topical 2 per cent lidocaine, 0.5 per cent bupivacaine and 1 per cent ropivacaine in dogs. Vet Rec 2014; 174:478. [PMID: 24622508 DOI: 10.1136/vr.102189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The objective of this study was to describe and compare the efficacy and duration of topical anaesthesia induced by 2 per cent lidocaine (L), 0.5 per cent bupivacaine (B) and 1 per cent ropivacaine (R) in the dog using 24 clinically healthy beagles with normal ocular examination. Dogs were randomly divided into three groups: 2 per cent lidocaine (n=8), 0.5 per cent bupivacaine (n=8) and 1 per cent ropivacaine (n=8). The baseline corneal touch threshold (CTT) was measured using a Cochet-Bonnet aesthesiometer. Following baseline CTT measurement, a single drop of the assigned anaesthetic was applied to each eye and the CTT was measured bilaterally within one minute after administration and every five minutes until the basal CTT value was restored. Data were analysed with non-parametric analysis of variance models and Dunnet's test for post hoc analysis. One per cent ropivacaine was the most effective drug (LCTTmax=3 cm, BCTTmax=2 cm, RCTTmax=0 cm; P<0.001), and had the shortest latency (LLatency=5 minutes, BLatency=5 minutes, RLatency=1 minute; P<0.001) and the smallest AUC (LAUC=80 cm×minute, BAUC=68.25 cm×minute, RAUC=36.88 cm×minute; P<0.001). There was no statistical difference in the duration of corneal anaesthesia between the groups (P=0.09) and all topical anaesthetics tested reduced corneal sensitivity, although 1 per cent ropivacaine had the maximal and quickest anaesthetic effect. This drug could be used for specific diagnostic procedures where quick and short, but effective, corneal anaesthesia is needed.
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Affiliation(s)
- D Costa
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra 08193, Barcelona, Spain
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de Linde Henriksen M, Brooks DE. Standing ophthalmic surgeries in horses. Vet Clin North Am Equine Pract 2014; 30:91-110. [PMID: 24680208 DOI: 10.1016/j.cveq.2013.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Standing ophthalmic surgery without general anesthesia allows for several routine ophthalmic procedures including eyelid lacerations and enucleations to be performed in the horse, but does contain increased risk of causing tissue damage arising from the inability to eliminate eye and head movements. Heavy sedation and local nerve blocks of the involved motor and sensory nerves are essential in achieving a good outcome from ophthalmic surgery in the nonanesthetized horse. The inability to use an operating microscope in standing surgery in horses prevents performing precise corneal and intraocular microsurgeries.
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Affiliation(s)
- Michala de Linde Henriksen
- Comparative Ophthalmology Service, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1352 Boyd Avenue, Saint Paul, MN 55108, USA.
| | - Dennis E Brooks
- Comparative Ophthalmology Service, Departments of Large and Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 Southeast 16th Avenue, Gainesville, FL 32608, USA
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Thomson SM, Oliver JA, Gould DJ, Mendl M, Leece EA. Preliminary investigations into the analgesic effects of topical ocular 1% morphine solution in dogs and cats. Vet Anaesth Analg 2013; 40:632-40. [DOI: 10.1111/vaa.12069] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 01/23/2013] [Accepted: 01/23/2013] [Indexed: 11/28/2022]
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Miller C, Utter ML, Beech J. Evaluation of the effects of age and pituitary pars intermedia dysfunction on corneal sensitivity in horses. Am J Vet Res 2013; 74:1030-5. [DOI: 10.2460/ajvr.74.7.1030] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Labelle AL, Clark-Price SC. Anesthesia for Ophthalmic Procedures in the Standing Horse. Vet Clin North Am Equine Pract 2013; 29:179-91. [DOI: 10.1016/j.cveq.2012.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Pucket JD, Allbaugh RA, Rankin AJ, Ou Z, Bello NM. Comparison of efficacy and duration of effect on corneal sensitivity among anesthetic agents following ocular administration in clinically normal horses. Am J Vet Res 2013; 74:459-64. [DOI: 10.2460/ajvr.74.3.459] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sharrow-Reabe KL, Townsend WM. Effects of action of proparacaine and tetracaine topical ophthalmic formulations on corneal sensitivity in horses. J Am Vet Med Assoc 2012; 241:1645-9. [DOI: 10.2460/javma.241.12.1645] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wieser B, Tichy A, Nell B. Correlation between corneal sensitivity and quantity of reflex tearing in cows, horses, goats, sheep, dogs, cats, rabbits, and guinea pigs. Vet Ophthalmol 2012; 16:251-62. [PMID: 23067275 DOI: 10.1111/j.1463-5224.2012.01069.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Guinea pigs have a very low threshold of corneal sensitivity and at the same time nearly no reflex tearing compared to dogs, cats, and horses. The question arose whether there is a general correlation between corneal sensitivity and the quantity of reflex tearing. ANIMALS STUDIED Totally 160 animals of 8 different species (20 animals per species) were investigated. PROCEDURES The corneal touch threshold (CTT) was measured with a Cochet-Bonnet esthesiometer. The palpebral fissure length (PFL) was measured with a calliper ruler. The Schirmer tear test (STT) was modified by adapting the width of the STT strip to the PFL of every species. For the STT II, 0.4% oxybuprocaine was applied. RESULTS Corneal touch threshold: Cows (1.67 g/mm(2)), horses (1.23 g/mm(2)), sheep (1.13 g/mm(2)), goats (1.44 g/mm(2)), dogs (2.16 g/mm(2)), and cats (1.33 g/mm(2)) show similar CTT values. In contrast, rabbits (6.21 g/mm(2)) and guinea pigs (7.75 g/mm(2)) show a significantly lower CTT. Tear Production Difference STT I - STT II: Rabbits have the greatest decline in tear production with 38.4%, followed by sheep (33.3%), dogs (31.1%), cats (24.7%), cows (23.7%), horses (18.0%), and goats (14.0%). Guinea pigs have no decline, but a slight increase of -16.0%. Correlation CTT and STT II - STT I Difference: Pearson's correlation coefficient shows a small, but significant correlation. The coefficient of determination can only forecast a value with 7.1% certainty. CONCLUSIONS The high variance and low reproducibility of results suggest that the measuring devices are inappropriate to assess the evaluated parameters. Therefore, no assured correlation between the corneal sensitivity and the quantity of reflex tearing could be found.
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Affiliation(s)
- Barbara Wieser
- Department for Small Animals and Horses, Clinic for Surgery and Ophthalmology, University of Veterinary Medicine Vienna, Rautenkranzgasse 36/11, Vienna 1210, Austria.
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Trbolova A, Gionfriddo JR, Ghaffari MS. Results of Schirmer tear test in clinically normal llamas (Lama glama). Vet Ophthalmol 2012; 15:383-5. [DOI: 10.1111/j.1463-5224.2012.01002.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Parchen H, Izar M, Branco P, Lacowicz C, Sano D, Belo C, Vilani R. Ophthalmic and anesthetic evaluation of topical 1% tetracaine and 0.5% proparacaine in dogs. ARQ BRAS MED VET ZOO 2011. [DOI: 10.1590/s0102-09352011000600009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to establish the action of 1% tetracaine eye drops in combination with 0.1% phenylephrine in two different posologies and their effects on the eye compared to the 0.5% proparacaine drops in dogs. 22 animals were divided into two groups: TG (11 animals), received 1% tetracaine associated with 0.1% phenylephrine eye drops, one drop instilled in the left eye and two drops, with one-minute interval between each, instilled in the right eye; PG (11 animals) received 0.5% proparacaine eye drops following the same dosage. The average duration of the observed anesthetic action was 25 minutes for tetracaine and 15 minutes for proparacaine. The instillation of two drops increased anesthetic time in five minutes. No changes in intraocular pressure, pupil diameter and tear production was observed. The drops of tetracaine triggered chemosis in four (36.4%) animals. Topical anesthesia with proparacaine eye drops showed no adverse reactions and is thus recommended preferentially.
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Clark JS, Bentley E, Smith LJ. Evaluation of topical nalbuphine or oral tramadol as analgesics for corneal pain in dogs: a pilot study. Vet Ophthalmol 2011; 14:358-64. [DOI: 10.1111/j.1463-5224.2011.00883.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Monclin SJ, Farnir F, Grauwels M. Determination of tear break-up time reference values and ocular tolerance of tetracaine hydrochloride eyedops in healthy horses. Equine Vet J 2010; 43:74-7. [PMID: 21143637 DOI: 10.1111/j.2042-3306.2010.00119.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
REASONS FOR PERFORMING STUDY Tetracaine hydrochloride (THCl) has been reported to cause irritation in dogs. In man, some topical anaesthetics have been shown to disrupt the tear film. Tear break-up time (TBUT) is a useful test allowing an assessment of the quality of the precorneal tear film. Only one TBUT value has been reported in horses with no information on the technique used. OBJECTIVES To provide a method for performing the TBUT in horses and to report any side effects of a single application of THCl in clinically normal horses, particularly on the stability of the tear film. METHODS In Study 1, one drop of 0.5 or 1% THCl was applied to one eye of 20 horses divided in 2 groups. Treated eyes were assessed for the development of side effects 2.5 and 5 min after treatment. In Study 2, the TBUT was measured in both eyes of 2 groups of 10 horses, before and 2.5 and 5 min after, instillation of one drop of either 0.5 or 1% THCl. RESULTS No animals developed any ocular side effect after instillation. Basal TBUT was 8.3±1.3 s. TBUT decreased from baseline 5 and 2.5 min after application of one drop of 0.5% THCl and one drop of 1% THCl, respectively. CONCLUSIONS A technique to measure the TBUT in healthy horses is described and normal range values that could be used as a reference were obtained. POTENTIAL RELEVANCE THCl is well tolerated in horses but lowers the TBUT.
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Affiliation(s)
- S J Monclin
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Liège University, Liège, Belgium.
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MONCLIN SJ, FARNIR F, GRAUWELS M. Duration of corneal anaesthesia following multiple doses and two concentrations of tetracaine hydrochloride eyedrops on the normal equine cornea. Equine Vet J 2010; 43:69-73. [DOI: 10.1111/j.2042-3306.2010.00118.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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HUBBELL JAE, SAVILLE WJA, BEDNARSKI RM. The use of sedatives, analgesic and anaesthetic drugs in the horse: An electronic survey of members of the American Association of Equine Practitioners (AAEP). Equine Vet J 2010; 42:487-93. [DOI: 10.1111/j.2042-3306.2010.00104.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Wotman KL, Utter ME. Effect of treatment with a topical ophthalmic preparation of 1% nalbuphine solution on corneal sensitivity in clinically normal horses. Am J Vet Res 2010; 71:223-8. [DOI: 10.2460/ajvr.71.2.223] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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