Cooling Anesthesia for Intravitreal Injections - A Review.
Priya R ChandrasekaranAamir A AzizHannah KhanArshad M KhananiPublished in: Clinical ophthalmology (Auckland, N.Z.) (2023)
Intravitreal (IVT) injections are the most common procedure performed in retinal clinics today. It has revolutionized the treatment of neovascular age-related macular degeneration (nAMD), diabetic macular edema, macular edema due to veinous occlusive disease and other forms of exudative maculopathy. Though IVT injections prevent vision loss, the discomfort at the time of the injection has been troublesome to patients. This has led to patients missing their regular and routine dosage of treatment. Various modes of pre-injection anesthetic methods have been tried but in vain. Lidocaine-based topical anesthesia, in the form of pledgets, topical gel or subconjunctival lidocaine injection, has been the standard of care (SOC) for IVT injections worldwide. This article highlights the role of cooling anesthesia in reducing pain, anxiety and discomfort associated with needle penetration at the time of injection. PubMed and MedLine search were related to anesthesia for intravitreal injections, cooling anesthesia, mechanism of cooling anesthesia, COOL-1 trial, COOL-2 trial, results of COOL-1 trial and ultrarapid cooling anesthesia.
Keyphrases
- age related macular degeneration
- ultrasound guided
- end stage renal disease
- diabetic retinopathy
- ejection fraction
- chronic kidney disease
- platelet rich plasma
- vascular endothelial growth factor
- study protocol
- healthcare
- phase iii
- optical coherence tomography
- randomized controlled trial
- pain management
- depressive symptoms
- physical activity
- patient reported outcomes
- quality improvement
- spinal cord injury
- sickle cell disease
- drug induced