Assisted Local Anesthesia for Powered Endoscopic Dacryocystorhinostomy

Purpose: The role of assisted local anaesthetic (aLA) for both endoscopic and external dacryocystorhinostomy is a well-tolerated and established approach. However the tolerability of aLA is unclear with powered burrs used in powered endoscopic DCR (PEDCR). We aim to evaluate the acceptability of aLA for PEDCR. Methods: This is a prospective, interventional, non-randomized, non-comparative, single surgeon study. Consecutive series of patients that underwent PEDCR performed under aLA were included in the study. Tolerability was assessed by intra-operative pain score on 100 point visual analogue scale (VAS) and if patients were willing to have aLA-PEDCR again. Results: A total of 44 PEDCR was performed on 42 patients. 56% of patients reported 0 on 100 point VAS, 65.9% (29/44) reported 510, 88.6% (39/44) reported 520 and no patients had score of 430/100. 97.7% (43/44) of patients are happy to have PEDCR performed again under aLA. The one patient unwilling to have a repeat aLA-PEDCR was not because of pain but intolerance to the sound of drilling. Conclusion: PEDCR with assisted local anaesthetic is well tolerated and accepted by patients.