Pharmaceutical composition for the treatment of pain and reduce inflammation in ophthalmology

 

(57) Abstract:

The invention relates to medicine, namely to ophthalmology, and relates to a composition for pain relief and reduce inflammation. The invention lies in the fact that the drug includes a local anesthetic, heparin, viscoelastic and additionally contains adrenaline and non-steroidal anti-inflammatory agents. The invention provides a reduction in the number of complications during and after surgery and diagnostic procedures in the anterior segment of the eye, but also increases the comfort level and pain management of the patient throughout the surgery or procedure.

The invention relates to medicine, namely to ophthalmology, and can be used for abdominal eye operations (including extraction (phacoemulsification) cataract with IOL implantation) to the internal chamber of anesthesia and pain with non-invasive surgical and diagnostic manipulations on the front segment of the eye (the removal of stitches, pneumatici, radial keratotomy, lamellar and interlamellar keratoplasty, penetrating deep sclerectomy, laser photocoagulation of the retina and so on, as well as gonioscopy, fundus examination TNA pharmaceutical composition for anesthesia in ophthalmology, including a local anesthetic, viscoelastic and heparin (RF patent N 2147876 dated 08.07.1999 year). It is used when performing abdominal eye operations and injected intraoperatively in the anterior chamber of the eye. When non-invasive surgical and diagnostic manipulations on the front segment of the eye viscoelastic applied to the cornea or instilled into the conjunctival cavity.

The disadvantage of applying the composition as proposed is that with long-term operation becomes weak analgesic effect and the patient begins to feel pain, and in the postoperative period is marked inflammatory reaction on the part of the eye (the exudate in the anterior chamber, peritoneally injection and so on).

The task of the invention is to achieve effective and long-lasting anesthesia throughout the surgical and diagnostic procedures and reducing the inflammatory response of the eye in the postoperative period.

The technical result is to decrease the number of complications during and after surgery and diagnostic procedures, as well as increasing the comfort level and pain management of the patient throughout the surgery is Bolivia in ophthalmology, including a local anesthetic, heparin and viscoelastic, according to the invention additionally contains adrenaline and non-steroidal anti-inflammatory agents in the following ratio, wt.%:

A local anesthetic is 0.01 to 4.0

The heparin units/ml 5-500

Adrenaline is 0.0015-0,005

Nonsteroidal anti-inflammatory agents is 0.0001-2

Viscoelastic - Rest

An advantage of the claimed pharmaceutical compositions for anesthesia in ophthalmology, adrenaline, and being-adrenomimetics, provides local constricting action on the vessels of the iris, conjunctiva and other structures of the eye. As a consequence, significantly decreases the absorption of the anesthetic into the bloodstream and therefore fewer anesthetic is more lasting and effective anesthesia. The concentration of adrenaline due to the fact that the lower concentration has no local vasodilatory action, and has a higher effect on the General condition of the body (heart palpitations, increased blood pressure and so on).

Anti-inflammatory effect of nonsteroidal anti-inflammatory agents (indomethacin, diclofenac-sodium, cetral and so on) is capillaries and microcirculation; b) inhibition of the activity of enzymes involved in the formation of "mediators of inflammation"; antihyaluronidase activity; g) fibrinolytic activity; d) inhibitory effect on the synthesis of prostaglandins; (e) a stabilizing effect on membranes of lysosomes, etc.

Example 1. Patient J. 52 years with a diagnosis of left eye: immature complicated cataract, myopia of an average degree. During the operation of cataract phacoemulsification with IOL implantation the patient produced mechanical dilatation of the pupil with the introduction to anesthesia proposed pharmaceutical composition. In front of the camera eye was administered pharmaceutical composition (through an irrigation system delivery) in an amount of 0.3 ml in the following ratio, wt.%:

Denain - 0,05

The heparin units/ml - 5

Adrenaline is 0.0015

Diclofenac - 0,0001

0.1% sodium Hyaluronate - Rest

During the operation, the width of the pupil was 8 mm, the Patient felt no pain. The postoperative period was without complications. Loss of endothelial cells did not exceed 5-6% in the observation period up to 6 months after surgery. The inflammatory response was absent.

Example 2. A patient 53 years with diagnosable. During the operation of cataract phacoemulsification with IOL implantation produced mechanical dilatation of the pupil with the introduction of anesthesia in front of the camera 0.5 ml of the proposed pharmaceutical composition in the following ratio, wt.%:

Marcain - 1,0

Lidocain - 1,0

The heparin units/ml - 200

Adrenaline is 0.0015

Ketorolac - 0,002

3% Hyaluronate sodium - Rest

During surgery, the patient pain or pain is not felt. Throughout it was achieved adequate surgical requirements mydriasis. As a result, the surgery went quickly and without complications. The postoperative period was without complications. Loss of endothelial cells did not exceed 5-6% in the observation period up to 6 months after surgery.

Example 3. Patient P. 62 years with a diagnosis of right eye: immature complicated cataract, pseudoexfoliation syndrome. During the operation of cataract phacoemulsification with IOL implantation produced mechanical dilatation of the pupil with the introduction of anesthesia in front of the camera 0.5 ml of the proposed pharmaceutical composition in the following ratio, wt.%:

Mydomain - 0,05

The heparin units/ml - 500

Adrenaline - 0,002
< was achieved adequate surgical requirements anesthesia. As a result, the surgery went quickly and without complications. The postoperative period was calm. Loss of endothelial cells did not exceed 5-6% in the observation period up to 6 months after surgery.

Example 4. Patient L. 53-years with a diagnosis of left eye: immature age-related cataract with IOL implantation, the patient produced anesthesia is injected into the anterior chamber of 0.5 ml of the pharmaceutical composition in the following ratio, wt.%:

Marcain - 0,01

The heparin units/ml - 5

Adrenaline is 0.0015

Indomethacin - 0,03

6,0% Hydroxypropylcellulose - Rest

During surgery, the patient pain or pain is not felt. The postoperative period was without complications. Loss endothelially cells did not exceed 5-6% in the observation period up to 6 months after surgery.

Example 5. Patient N. 22-years with a diagnosis of left eye: immature innate tadakamalla cataract. Patients performed phacoemulsification (aspiration) with IOL implantation. During the irrigation capsulorhexis and aspiration of cataract with IOL implantation with the purpose of the anesthesia in the anterior chamber of the eye as the irrigation fluid was administered pharmaceutical composition is Rin, IU/ml - 5

Adrenaline - 0,0025

Ketorolac - 0,001

0,01% Methylhydroxyethylcellulose - Rest

During the whole operation was achieved adequate surgical anesthesia, the patient pain or pain is not felt. The postoperative period was without complications. Loss of endothelial cells did not exceed 5-6% in the observation period up to 6 months after surgery.

Thus, the proposed pharmaceutical composition for anesthesia in ophthalmology is a complex drug that has long pronounced analgesic and anti-inflammatory action.

Pharmaceutical composition for the treatment of pain, including local anesthetic, heparin and viscoelastic, characterized in that it additionally contains adrenaline and non-steroidal anti-inflammatory agents in the following ratio, wt.%:

A local anesthetic is 0.01 to 4.0

The heparin units/ml - 5 - 500

Adrenaline is 0.0015 - 0,005

Nonsteroidal anti-inflammatory agents is 0.0001 - 0,005

Viscoelastic - Rest

 

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