comparing the effects of lidocaine/paracetamol and midazolam/fentanyl as a premedication on pain intensity and hemodynamic changes in patients undergoing cataract surgery with topical anesthesia: a randomized double-blinded pilot study

Background: several supplementary approaches have been used to increase the patient rsquo;s comfort during phacoemulsification under topical anesthesia.objective: this study aimed to compare the effects of lidocaine/paracetamol (lp) and midazolam/fentanyl (mf) administration on pain intensity and hemodynamic changes in patients undergoing cataract surgery using phacoemulsification. methods: this study was designed and implemented as a pilot randomized double-blinded clinical trial. a total number of 80 patients with cataracts scheduled for phacoemulsification were randomly assigned to two groups (40 subjects in each group) to receive lidocaine at a dose of 1.5 mg/kg and then infused with 1 g of paracetamol in 100 cc of normal saline (lp group) or midazolam 0.2 mg/kg and fentanyl 1.5 micro;g/kg (mf group). hemodynamic parameters and sedation scores were measured before, 5, and 15 minutes after surgery, and then during recovery. furthermore, pain (vas), patient-surgeon satisfaction, propofol, and opioid consumption were all assessed.findings: the sedation scores during recovery in the lp group were significantly lower (p= 0.04) than those in the mf group. respiratory depression was also significantly lower (p<0.001) in the lp group compared to that infused by mf. according to other findings, no significant difference was observed between both study groups.conclusion: the use of lidocaine-paracetamol as a supplementary approach for patients undergoing cataract surgery under topical anesthesia can cause better sedation scores with lower respiratory depression compared to the use of midazolam-fentanyl.