Application of low-concentration topical anesthetics in ophthalmic surgery
By optimizing the administration method of low-concentration topical anesthetics, the problems of discomfort and corneal damage caused by conventional concentrations of drugs were solved, achieving safe and effective postoperative analgesia and healing.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- 保定市第一中心医院
- Filing Date
- 2026-04-22
- Publication Date
- 2026-06-02
AI Technical Summary
In the prior art, although topical anesthetics of conventional concentrations can relieve pain when used locally after ophthalmic surgery, they can also cause discomfort, foreign body sensation, increase corneal epithelial cell toxicity, delay corneal healing, and increase the risk of dry eye and corneal damage.
The use of topical anesthetics at lower concentrations than conventional methods, along with optimization of anesthetic concentration and administration methods, including selecting low-toxicity drugs, adjusting administration frequency and concentration, real-time monitoring, and gradual withdrawal, ensures both analgesic efficacy and safety.
It effectively relieves postoperative pain and discomfort, reduces corneal epithelial cell toxicity, promotes corneal healing, reduces dry eye and corneal damage, and improves patient compliance and eye comfort.
Smart Images
Figure CN122124033A_ABST
Abstract
Description
Technical Field
[0001] This invention relates to the field of low-concentration topical anesthetics application technology, specifically the application of low-concentration topical anesthetics in ophthalmic surgery. Background Technology
[0002] Currently, there are many types of ophthalmic surgeries, covering multiple fields from vision correction to eye disease treatment, including common ophthalmic surgeries such as pterygium excision and refractive surgery. Topical anesthetics are a class of highly penetrating local anesthetics that mainly reduce local sensitivity by blocking the transmission of nerve ending signals. They are often used for anesthesia of superficial areas such as skin and mucous membranes. When applied to the skin or mucous membrane surface, they can temporarily block the transmission of pain signals from nerve endings to achieve an analgesic effect. The onset time of these drugs is usually 2-3 minutes, making them suitable for short-term, superficial intervention needs. Currently, in ophthalmic surgery, topical anesthetics are often used at conventional concentrations for local administration after surgery. While this can effectively relieve postoperative pain, it can cause discomfort and a foreign body sensation in the eye. Furthermore, using topical anesthetics at conventional concentrations can significantly increase the toxicity to corneal epithelial cells, delay corneal healing, and damage dry eye and the cornea, making the eye more prone to adverse reactions during postoperative administration. Summary of the Invention
[0003] This invention provides the application of low-concentration topical anesthetics in ophthalmic surgery, which can effectively solve the problems mentioned in the background art. Currently, in the application of topical anesthetics in ophthalmic surgery, conventional concentrations of topical anesthetics are often used for local administration after ophthalmic surgery. Although this can effectively relieve postoperative pain, discomfort and foreign body sensation may occur after administration to the eye. Furthermore, the use of conventional concentrations of topical anesthetics can significantly increase the toxicity to corneal epithelial cells, delay corneal healing, damage dry eye and cornea, and make the eye prone to adverse reactions during postoperative administration.
[0004] To achieve the above objectives, the present invention provides the following technical solution: the application of low-concentration topical anesthetics in ophthalmic surgery, using topical anesthetics with a concentration lower than that of conventional anesthesia for local administration after ophthalmic surgery, and improving medication safety and patient compliance by optimizing the concentration of anesthetics and the method of administration; The specific application process includes the following: Step S1: Confirm the patient's basic surgical condition before administering medication; Step S2: Select the anesthetic drug and optimize the dosage; Step S3: Perform the drug administration procedure according to the specific circumstances; Step S4: Monitor and adjust the drug dosage in real time. Step S5: Gradually reduce and gradually withdraw the medication.
[0005] According to the above technical solution, step S1 requires clarifying the type of surgery performed on the patient and the basic condition of the patient's eyes; The patients' surgical procedures mainly include refractive surgery, pterygium excision, and complex corneal transplantation. The degree of trauma of the patient's eye surgery needs to be distinguished according to the specific type of surgery. The greater the degree of trauma of the patient's surgery, the lower the postoperative pain threshold. When determining the medication, the dosage intensity needs to be adjusted according to the actual degree of trauma of the patient.
[0006] According to the above technical solution, in step S1, when clarifying the basic condition of the patient's eyes, it is necessary to check the integrity of the cornea and the tear secretion function to rule out severe dry eye syndrome and corneal epithelial defects. It is also necessary to assess the patient's conjunctival condition.
[0007] According to the above technical solution, in step S2, when selecting anesthetic drugs, drugs with lower toxicity and less irritation are given priority, and the drug effect is improved through dosage form optimization. When selecting specific anesthetic drugs, choose topical anesthetics with low toxicity to epithelial cells, including promecaine and lidocaine. When optimizing the drug concentration, the concentration is mainly based on the conventional concentration of the drug, and is set to be 1 / 5 to 1 / 10 of the conventional anesthetic concentration.
[0008] According to the above technical solution, in step S2, when optimizing the dosage form of anesthetic drugs, a buffer is specifically added to the eye drops to adjust the pH value of the eye drops to 7.0-7.4.
[0009] According to the above technical solution, in step S3, when administering medication, it is necessary to determine the timing of administration, specifically before the onset of pain and in the early stage of pain. The timing of administration should be determined based on the patient's specific surgical condition to avoid administering medication immediately after surgery. Specifically, when a patient undergoes minimally invasive refractive surgery, medication should be administered 2-4 hours after the anesthesia wears off, when the patient experiences a mild foreign body sensation. When a patient undergoes invasive surgery, a prophylactic dose should be administered once after the patient has fully regained consciousness from anesthesia, i.e., after the surgery is completely completed. Subsequent doses should be administered as needed based on the actual situation.
[0010] According to the above technical solution, in step S3, when performing the drug administration operation, the drug is mainly administered through local eye drops. It is necessary to verify the name, concentration and expiration date of the eye drops. During the eye drop operation, the patient should be in a supine position with their head slightly tilted back and their eyes looking upward. Then, gently pull down the lower eyelid to form the conjunctival sac, so that the mouth of the eye drop bottle is 2-3 cm away from the eye surface. 1-2 drops are instilled into each eye each time. After each eye drop administration, the patient should close their eyes and rest for 2-3 minutes to allow the drug to be evenly distributed on the corneal surface. In addition, the frequency of administration needs to be controlled during the administration process. Specifically, within 24 hours after the operation, the drug needs to be administered once every 4-6 hours, 4-6 times a day, and the dosage should be controlled to 1-2 drops per eye per administration, with a total dosage of 25-50 μL per eye per administration. 24 hours after the surgery, the frequency of medication needs to be adjusted according to the patient's specific pain level, specifically 2-4 times a day.
[0011] According to the above technical solution, step S4 is to optimize the drug in real time based on the patient's response after the patient has been given the drug, and to balance the analgesic effect and safety of the low-concentration topical anesthetic drug by adjusting the drug. When monitoring and providing feedback on the analgesic effect, the main methods used are to examine the healing and integrity of the patient's corneal epithelium with a slit lamp, as well as to check the stability of the tear film. At the same time, we also observe whether the patient rubs their eyes, frowns, or exhibits painful behaviors, and whether the patient blinks frequently to indicate that the foreign body sensation has not been relieved, in order to objectively judge the patient's actual response. If the analgesic effect is monitored and it is found that the patient's analgesia is insufficient, the dosing frequency can be increased to once every 3 hours for a short period of time, with a daily dosing frequency of ≤8 times. At the same time, a 0.15% concentration of topical anesthetic can be used as an alternative for administration.
[0012] According to the above technical solution, in step S4, during drug administration safety monitoring, it is necessary to observe the degree of conjunctival hyperemia and corneal transparency daily, and gently touch the center of the cornea with cotton wool to record the patient's perception time. If the perception recovery time is >7 days, the drug concentration of the topical anesthetic needs to be reduced and the frequency of administration reduced. Specifically, the drug concentration is reduced to 0.05%, and the frequency of administration is reduced to once every 8-10 hours. If large-scale corneal epithelial shedding and reduced tear secretion occur, it indicates a toxic reaction, and the medication should be discontinued immediately and replaced with artificial tears.
[0013] According to the above technical solution, in step S5, during the postoperative drug administration process, the patient's dependence on anesthetic drugs is reduced by gradually decreasing the dosage and frequency of administration, and the repair of the patient's ocular surface nerve is promoted by reducing and withdrawing the drug. When reducing medication, the reduction should be done according to the completion time of the patient's eye surgery. During the transitional withdrawal of medication, starting from the 5th day after surgery, medication is switched to on-demand administration, used only when the patient experiences pain. Starting from the 7th day after surgery, topical anesthetics are completely discontinued. If the patient experiences discomfort after discontinuation of medication, artificial tears are used instead.
[0014] Compared with the prior art, the beneficial effects of the present invention are as follows: This invention improves medication safety and patient compliance while ensuring analgesic efficacy by optimizing anesthetic drug concentration and administration method. Furthermore, by using a topical anesthetic drug at a lower concentration than conventional anesthetic for local administration after ophthalmic surgery, it can effectively relieve postoperative pain, discomfort, and foreign body sensation while significantly reducing toxicity to corneal epithelial cells, thus reducing adverse reactions such as delayed corneal healing, dry eye, and corneal damage. It is effectively applicable to analgesia management after pterygium excision, refractive surgery, and other common ophthalmic surgeries, and has good clinical application value. Furthermore, by applying low-concentration topical anesthetics after ophthalmic surgery, the entire process of medication assessment, drug selection optimization, corresponding administration, monitoring and adjustment, and gradual withdrawal is carried out in the specific application process. Through precise control of the dosage concentration, individualized targeted administration, and dynamic monitoring, the dual goals of effective analgesia and ocular surface protection are achieved. This effectively controls postoperative discomfort in patients while minimizing corneal toxicity, thereby improving postoperative comfort and visual quality in patients. Attached Figure Description
[0015] The accompanying drawings are provided to further illustrate the invention and form part of the specification. They are used together with the embodiments of the invention to explain the invention and do not constitute a limitation thereof.
[0016] In the attached diagram: Figure 1 This is a flowchart illustrating the application of the low-concentration topical anesthetic of this invention in ophthalmic surgery. Detailed Implementation
[0017] The preferred embodiments of the present invention will be described below with reference to the accompanying drawings. It should be understood that the preferred embodiments described herein are for illustration and explanation only and are not intended to limit the present invention.
[0018] Example: Figure 1 As shown, the present invention provides a technical solution for the application of low-concentration topical anesthetics in ophthalmic surgery. It uses topical anesthetics with a concentration lower than that of conventional anesthesia for local administration after ophthalmic surgery, and improves medication safety and patient compliance by optimizing the concentration of anesthetics and the method of administration. The specific application process includes the following: Step S1: Confirm the patient's basic surgical condition before administering medication; Step S2: Select the anesthetic drug and optimize the dosage; Step S3: Perform the drug administration procedure according to the specific circumstances; Step S4: Monitor and adjust the drug dosage in real time. Step S5: Gradually reduce and gradually withdraw the medication.
[0019] Based on the above technical solution, step S1 requires clarifying the type of surgery performed on the patient and the basic condition of the patient's eyes to provide a basis for subsequent specific drug administration operations; The patients' surgical procedures mainly include refractive surgery, pterygium excision, and complex corneal transplantation. The degree of trauma from the eye surgery needs to be differentiated according to the specific type of surgery. Among them, the degree of trauma from refractive surgery is less than that from pterygium excision, which is less than that from complex corneal transplantation. The greater the degree of trauma from the surgery, the lower the postoperative pain threshold. When determining the medication, the dosage intensity needs to be adjusted according to the actual degree of trauma to the patient.
[0020] Based on the above technical solution, in step S1, when clarifying the basic condition of the patient's eyes, it is necessary to check the integrity of the cornea and the tear secretion function, exclude severe dry eye syndrome and corneal epithelial defects, and screen patients who are more sensitive to such topical anesthetics to facilitate the reduction of the concentration of topical anesthetics and the shortening of the course of treatment according to the actual situation. It is also necessary to assess the patient's conjunctival condition to avoid drug penetration obstruction. The patient's conjunctival condition includes whether there is inflammation or scarring.
[0021] Based on the above technical solution, in step S2, when selecting anesthetic drugs, priority is given to drugs with lower toxicity and less irritation, and the drug effect is improved through dosage form optimization. When selecting specific anesthetic drugs, choose topical anesthetics with low toxicity to epithelial cells, including promecaine and lidocaine, and avoid using high-concentration and highly toxic ester anesthetic drugs. When optimizing the dosage concentration, the dosage concentration is mainly based on the conventional concentration of the drug, and is set to 1 / 8 of the conventional anesthetic concentration. Specifically, the conventional concentration of promecaine is 0.5%, and the postoperative dosage concentration is controlled at 0.0625%. The conventional concentration of lidocaine is 3%, and the postoperative dosage concentration is controlled at 0.375%.
[0022] Based on the above technical solution, in step S2, when optimizing the dosage form of anesthetic drugs, a buffer is specifically added to the eye drops. The buffer is selected as boric acid-borax buffer solution. The pH value of the eye drops is adjusted to 7.2 by the buffer to reduce the irritation caused by subsequent administration.
[0023] Based on the above technical solution, in step S3, when administering medication, it is necessary to determine the timing of administration, specifically before the onset of pain and in the early stage of pain, to avoid severe pain inducing eye rubbing and causing secondary damage. When determining the timing of administration, it is necessary to determine it according to the patient's specific surgical condition to avoid administering medication immediately after surgery. Specifically, when a patient undergoes minimally invasive refractive surgery, medication should be administered after the anesthesia wears off, that is, within 4 hours after the surgery, when the patient experiences a mild foreign body sensation. When a patient undergoes invasive surgery, such as pterygium excision or complex corneal transplantation, a prophylactic dose should be administered once after the patient has fully regained consciousness from anesthesia, that is, after the surgery is completely completed. Subsequent doses should be administered as needed based on the actual situation.
[0024] Based on the above technical solution, in step S3, when performing the drug administration operation, the drug is mainly administered through local eye drops. It is necessary to verify the name, concentration and expiration date of the eye drops. During the eye drop operation, the patient should be in a supine position with their head slightly tilted back and their eyes looking upward. Then, gently pull down the lower eyelid to form the conjunctival sac, so that the mouth of the eye drop bottle is 2cm away from the eye surface. Two drops are instilled into each eye each time. After each eye drop administration, the patient should close their eyes and rest for 3 minutes to allow the drug to be evenly distributed on the corneal surface. In addition, the frequency of administration needs to be controlled during the administration process. Specifically, within 24 hours after the operation, the drug needs to be administered once every 4 hours, 6 times a day, and the dosage should be controlled to 2 drops per eye per administration, with a total dosage of 30 μL per eye per administration. 24 hours after the surgery, the frequency of medication needs to be adjusted according to the patient's specific pain level, specifically to 3 times a day.
[0025] Based on the above technical solution, step S4 is to optimize the drug in real time according to the patient's response after the operation, and to balance the analgesic effect and safety of low-concentration topical anesthetic drug administration by adjustment. When monitoring and providing feedback on the analgesic effect, the main methods used are to examine the healing and integrity of the patient's corneal epithelium with a slit lamp, as well as to check the stability of the tear film. At the same time, we also observe whether the patient rubs their eyes, frowns, or exhibits painful behaviors, and whether the patient blinks frequently to indicate that the foreign body sensation has not been relieved, in order to objectively judge the patient's actual response. If the analgesic effect is monitored and it is found that the patient's analgesia is insufficient, the dosing frequency can be increased to once every 3 hours for a short period of time, with a daily dosing frequency of ≤8 times. At the same time, a 0.15% concentration of topical anesthetic can be used as an alternative for administration.
[0026] Based on the above technical solution, in step S4, when monitoring the safety of drug administration, it is necessary to observe the degree of conjunctival hyperemia and corneal transparency daily, and gently touch the center of the cornea with cotton wool to record the patient's perception time. If the perception recovery time is >7 days, the drug concentration of the topical anesthetic should be reduced and the frequency of administration should be reduced. Specifically, the drug concentration should be reduced to 0.05% and the frequency of administration should be reduced to once every 10 hours. When large-scale corneal epithelial shedding and reduced tear secretion occur, it indicates a toxic reaction. The medication should be stopped immediately and artificial tears should be used instead. 0.5% sodium carboxymethyl cellulose can be used to replace part of the topical anesthetic.
[0027] Based on the above technical solution, in step S5, during the postoperative drug administration process, the patient's dependence on anesthetic drugs is reduced by gradually decreasing the dosage and frequency of administration, and the repair of the patient's ocular surface nerve is promoted by reducing and withdrawing the drug. When reducing medication, the medication should be reduced on time according to the end time of the patient's eye surgery. Generally, the medication should be reduced 4 days after the operation, and no longer than 7 days, to avoid long-term use of medication that may inhibit the regeneration of corneal nerves. During the transitional withdrawal of medication, starting from the 5th day after surgery, medication is switched to on-demand administration, and is only used when the patient experiences pain. The concentration of the topical anesthetic used during the transition is 1 / 10 of the regular drug concentration. Starting from the 7th day after the patient's surgery, the topical anesthetic is completely discontinued. If the patient experiences discomfort after discontinuation of medication, artificial tears are used to promote epithelial repair.
[0028] Based on the above technical solution, eye drop packaging can be customized with different drop volume standards of 0.3ml and 0.4ml to suit different patients.
[0029] Finally, it should be noted that the above descriptions are merely preferred embodiments of the present invention and are not intended to limit the present invention. Although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art can still modify the technical solutions described in the foregoing embodiments or make equivalent substitutions for some of the technical features. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principles of the present invention should be included within the protection scope of the present invention.
Claims
1. The application of low-concentration topical anesthetics in ophthalmic postoperative care, characterized by: Topical anesthetics at concentrations lower than those used in conventional anesthesia are administered locally after ophthalmic surgery. By optimizing the concentration and administration method of the anesthetic, the safety of medication and patient compliance can be improved. The specific application process includes the following: Step S1: Confirm the patient's basic surgical condition before administering medication; Step S2: Select the anesthetic drug and optimize the dosage; Step S3: Perform the drug administration procedure according to the specific circumstances; Step S4: Monitor and adjust the drug dosage in real time. Step S5: Gradually reduce and gradually withdraw the medication.
2. The application of the low-concentration topical anesthetic according to claim 1 in postoperative ophthalmic surgery, characterized in that: Step S1 requires clarifying the type of surgery performed on the patient and the basic condition of the patient's eyes; The types of surgery performed on patients mainly include refractive surgery, pterygium excision, and complex corneal transplantation. The degree of trauma of the patient's eye surgery is distinguished according to the specific type of surgery. The greater the degree of trauma of the patient's surgery, the lower the postoperative pain threshold. When determining the medication, the dosage intensity needs to be adjusted according to the actual degree of trauma of the patient.
3. The application of the low-concentration topical anesthetic according to claim 2 in postoperative ophthalmic surgery, characterized in that: In step S1, when determining the basic condition of the patient's eyes, it is necessary to check the integrity of the cornea and the tear secretion function to rule out severe dry eye syndrome and corneal epithelial defects. It is also necessary to assess the patient's conjunctival condition.
4. The application of the low-concentration topical anesthetic according to claim 1 in postoperative ophthalmic surgery, characterized in that: In step S2, when selecting anesthetic drugs, priority is given to drugs with lower toxicity and less irritation, and the drug effect is improved through dosage form optimization. When selecting specific anesthetic drugs, choose topical anesthetics with low toxicity to epithelial cells, including promecaine and lidocaine. When optimizing the drug concentration, the concentration is mainly based on the conventional concentration of the drug, and is set to be 1 / 5 to 1 / 10 of the conventional anesthetic concentration.
5. The application of the low-concentration topical anesthetic according to claim 4 in postoperative ophthalmic surgery, characterized in that: In step S2, when optimizing the dosage form of the anesthetic drug, a buffer is added to the eye drops to adjust the pH value of the eye drops to 7.0-7.
4.
6. The application of the low-concentration topical anesthetic according to claim 1 in postoperative ophthalmic surgery, characterized in that: In step S3, when administering medication, it is necessary to determine the timing of administration, specifically before the onset of pain and during the initial stage of pain. The timing of administration is determined based on the patient's specific surgical condition. Specifically, when a patient undergoes minimally invasive refractive surgery, medication should be administered 2-4 hours after the anesthesia wears off, when the patient experiences a mild foreign body sensation. When a patient undergoes invasive surgery, a prophylactic dose should be administered once after the patient has fully regained consciousness from anesthesia, i.e., after the surgery is completely completed. Subsequent doses should be administered as needed based on the actual situation.
7. The application of the low-concentration topical anesthetic according to claim 6 in postoperative ophthalmic surgery, characterized in that: In step S3, the medication is mainly administered through local eye drops. The name, concentration, and expiration date of the eye drops must be verified. During the eye drop procedure, the patient should be in a supine position with their head slightly tilted back and their eyes looking upward. Then, the lower eyelid is gently pulled down to form the conjunctival sac, and the mouth of the eye drop bottle is 2-3 cm away from the eye surface. 1-2 drops are instilled into each eye at a time. After each eye drop administration, the patient should close their eyes and rest for 2-3 minutes to allow the medication to be evenly distributed on the corneal surface. In addition, the frequency of administration needs to be controlled during the administration process. Specifically, within 24 hours after the operation, the drug needs to be administered once every 4-6 hours, 4-6 times a day, and the dosage should be controlled to 1-2 drops per eye per administration, with a total dosage of 25-50 μL per eye per administration. 24 hours after the surgery, the frequency of medication needs to be adjusted according to the patient's specific pain level, specifically 2-4 times a day.
8. The application of the low-concentration topical anesthetic according to claim 1 in postoperative ophthalmic surgery, characterized in that: Step S4 involves real-time optimization based on the patient's response after the patient has received the medication, and adjustments are made to balance the analgesic effect and safety of the low-concentration topical anesthetic. During the monitoring and feedback of analgesic effects, the healing and integrity of the patient's corneal epithelium were examined using a slit lamp, as well as the stability of the tear film. At the same time, the patient's actual response was objectively judged by observing whether the patient rubbed their eyes, frowned, or exhibited painful behaviors, as well as whether the patient blinked frequently to indicate that the foreign body sensation had not been relieved. If the analgesic effect is monitored and it is found that the patient's analgesia is insufficient, the dosing frequency can be increased to once every 3 hours for a short period of time, with a daily dosing frequency of ≤8 times. At the same time, a 0.15% concentration of topical anesthetic can be used as an alternative for administration.
9. The application of the low-concentration topical anesthetic according to claim 8 in postoperative ophthalmic surgery, characterized in that: In step S4, during drug administration safety monitoring, the degree of conjunctival hyperemia and corneal transparency need to be observed daily. The center of the cornea is gently touched with cotton wool, and the patient's perception time is recorded. If the perception recovery time is >7 days, the concentration of the topical anesthetic needs to be reduced and the frequency of administration reduced. Specifically, the drug concentration is reduced to 0.05%, and the frequency of administration is reduced to once every 8-10 hours. If large-scale corneal epithelial shedding and reduced tear secretion occur, it indicates a toxic reaction, and the medication should be discontinued immediately and replaced with artificial tears.
10. The application of the low-concentration topical anesthetic according to claim 1 in postoperative ophthalmic surgery, characterized in that: In step S5, during the postoperative medication process, the patient's dependence on anesthetic drugs is reduced by gradually decreasing the dosage and frequency of administration, and the repair of the patient's ocular surface nerves is promoted by reducing and withdrawing the medication. When reducing medication, the dosage should be reduced on time according to the completion time of the patient's eye surgery; During the transitional withdrawal of medication, starting from the 5th day after surgery, medication is switched to on-demand administration, used only when the patient experiences pain. Starting from the 7th day after surgery, topical anesthetics are completely discontinued. If the patient experiences discomfort after discontinuation of medication, artificial tears are used instead.