Single Injection Infromedial Peribulbar Injection in Lacrimal Duct

Study Overview
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Brief Summary
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infromedial injection of 3 ml local anesthetic drugs and assessing the pain during lacrimal duct intubation and probability of false tracking

Detailed Description
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After entering the OR; the patient will be cannulated and fully monitored with basic monitors (pulse oximeter, NIBP & ECG), a nasal cannula is connected to the patient to deliver oxygen. We gave the patient 5 ml of propofol to decrease the discomfort felt by the patient during injection of local anesthesia. Benox eye drops is applied to the operative eye in both groups. Patients were allocated into 2 groups; each group is 25 patients Group 1: We used a 25G/ 1 length needle to inject 3ml of lidocaine: bupivacaine (1:1) with 30 IU hyaluronic acid, 0.5ml below the inferior punctum in the lower lid medial margin. Group 2: We used a 25G/ 1 length needle to inject 3ml of lidocaine: bupivacaine (1:1) with 30 IU hyaluronic acid classical medial canthal injection During surgery, we will assess the pain degree during probing using Verbal Rating Scale (0 to 10 scale where 0 is no pain an 10 is unbearable pain), to assess the efficiency of this single low volume injection.

Official Title
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Assessing the Effect of Single Injection Infromedial Peribulbar Injection in Lacrimal Duct Intubation Surgery in Adult Patient: Prospective Cohort Study

Conditions
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Pain Due to Certain Specified Procedures

Intervention / Treatment
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* Procedure: infromedial single injection
* Procedure: medial canthus injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adults undergoing lacrimal duct intubation surgery Patients' physical status by the American Association of Anesthesiology (ASA): ASA I, II, III. Age between 18-70, both sexes. Axial lengths ranging between 22-28mm. Exclusion Criteria: ASA IV. Patient age less than 18 or more than 70 years. Coagulation disorders (e.g. patients on warfarin (INR<1.5) Communication difficulties preventing reliable assessment. High myopia (axial length more than 28mm) and medial staphylomas.

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group 1<br>Infra- medial injection of local anesthesia mixture | Procedure: infromedial single injection<br>* Group 1: We used a 25G/ 1 length needle to inject 3ml of lidocaine: bupivacaine (1:1) with 30 IU hyaluronic acid, 0.5ml below the inferior punctum in the lower lid medial margin.<br>|
| Experimental: Group 2<br>medial canthus injection of the local anesthesia mixture | Procedure: medial canthus injection<br>* : We used a 25G/ 1 length needle to inject 3ml of lidocaine: bupivacaine (1:1) with 30 IU hyaluronic acid classical medial canthal injection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Verbal rating scale (VRS) is a 5 point scale from 0 to 4 where 0 is no pain and 4 is unbearable pain | pain scale | during surgery , study will started September 2021 & will end November 2022 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| surgery satisfaction using yes or no questionnaire | easiness and false tracking of the dilators | during surgery |