Effect of four local anesthetics (tetracaine, proparacaine, lidocaine, and bupivacaine) on intraocular pressure in dogs

Int Ophthalmol. 2019 Jul;39(7):1467-1474. doi: 10.1007/s10792-018-0969-0. Epub 2018 Jun 23.

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.

Keywords: Bupivacaine; Intraocular pressure; Lidocaine; Local anesthetic; Proparacaine; Tetracaine.

MeSH terms

  • Administration, Topical
  • Anesthesia, Local / methods*
  • Anesthetics, Local / administration & dosage
  • Animals
  • Bupivacaine / administration & dosage*
  • Disease Models, Animal
  • Dogs
  • Female
  • Glaucoma / etiology
  • Glaucoma / physiopathology
  • Glaucoma / prevention & control*
  • Intraocular Pressure / drug effects*
  • Lidocaine / administration & dosage*
  • Male
  • Propoxycaine / administration & dosage*
  • Tetracaine / administration & dosage*

Substances

  • Anesthetics, Local
  • Tetracaine
  • Lidocaine
  • proxymetacaine
  • Propoxycaine
  • Bupivacaine