Dilution of proparacaine in balanced salt solution reduces pain of anesthetic instillation in the eye.

Background And Objectives: Proparacaine (P), 0.5%, is often applied topically to the eye to diminish the pain of injection of anesthetic for eye surgery; however, application of 0.5% P itself can cause some degree of discomfort. This study evaluated the use of balanced salt solution to dilute P before instillation in the eye to prevent discomfort.

Methods: In a double-blinded manner, 42 consenting adults about to undergo cataract surgery were given 0.5% P in one eye and 0.03% P in the other eye. One minute later the same solutions were instilled into each eye. Ten minutes later, 0.5% P was instilled into both eyes. After each instillation the patients were asked to describe the pain in each eye on a 0 to 10 scale.

Results: Those receiving 0.5% as the first drop had a mean pain score of 1.28, which was greater than the score of 0.09 for the 0.03% P group (P < .01). No one reported pain after the second drop was applied 1 minute later. After receiving 0.5% P 10 minutes later, the group that had received 0.5% P reported a mean pain score of 0.09 while those who had received 0.03% P reported a score of 0.76, which was significantly greater than that reported by the 0.5% P group after the 10 minute instillation (P < .01) but significantly lower than the score reported after the first instillation of 0.5% P (P < .05).

Conclusions: Dilution of P in balanced salt solution to a concentration of 0.03% produces a solution that is significantly less painful than 0.5% P and reduces the discomfort of the instillation of 0.5% P.