A Study on Preoperative Xylocaine Sensitivity Test in Patients Undergoing Ocular Surgeries

Purpose: Xylocaine sensitivity testing is being practiced preoperatively in all patients undergoing ocular surgery under LA to prevent hypersensitivity reactions. With the current volume of ocular surgeries and the expected increase in the future, it becomes critical to optimize the safety of Preoperative xylocaine sensitivity testing.

Methods: The study comprised 400 patients (204 females & 196 males) aged 18 and above. The injection site was examined for all patients for wheal/erythema and itching, no reaction was seen after 10 min, 30 min, and 24 hours.

Results: After pre-operative xylocaine sensitivity test the patients are examined for wheal, flare, itching or any other reaction locally. Intraoperatively, Patients are assessed for systemic and local reactions to Peribulbar and retrobulbar block. XST was performed for all 400 patients included in the group and the reaction was recorded based on local reaction at the injection site. However, none of the patients showed any reaction to XST.

Conclusions: It has been recommended for decades that sensitivity testing before cataract surgery under LA should be undertaken as a routine precautionary measure. With changing paradigms in the type of anesthesia (topical becoming prevalent in advanced nations as well as urban centers in the developing world), there is a need to review the established protocols. Hence this study highlights the possibility of avoiding such tests in all patients before routine cataract surgery under LA.

With due precautions and resuscitation measures available on standby, it is theorized that routine testing for LA sensitivity may be skipped.