Drug reference
Mydriasis and intraocular anaesthesia during cataract surgery ▶BY INTRACAMERAL INJECTION ▶Adult: 0.2 mL for 1 dose, to be injected slowly at the Eye start of the surgical procedure DOSE EQUIVALENCE AND CONVERSION ▶Each 0.2 mL dose of Mydrane ® solution for injection contains 0.04 mg of tropicamide, 0.62 mg of phenylephrine hydrochloride and 2 mg of lidocaine hydrochloride.
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Cataract surgery combined with vitrectomy. history of acute, narrow-angle glaucoma. shallow anterior chamber
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Conditions where systemic exposure to phenylephrine or lidocaine could be harmful (consult product literature). risk of floppy iris syndrome (consult product literature)
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Contra-indicated in patients with known hypersensitivity to amide-type anaesthetics or atropine derivatives.
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Manufacturer advises patients must have demonstrated, at a previous visit, a satisfactory pupil dilation with topical mydriatic treatment.
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→Appendix 1: antiarrhythmics. sympathomimetics, vasoconstrictor. tropicamide
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▶Uncommon Headache. hyperaemia. hypertension. keratitis
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Manufacturer advises avoid (systemic uptake after administration cannot be excluded)—insufficient data available for phenylephrine and tropicamide in pregnancy; lidocaine crosses the placenta but is not known to be harmful in animal studies.
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Manufacturer advises avoid—no data available for phenylephrine or tropicamide; lidocaine present in milk in small amount.
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There can be variation in the licensing of different medicines containing the same drug. Solution for injection EXCIPIENTS: May contain Disodium edetate ▶Mydrane (Thea Pharmaceuticals Ltd) Tropicamide 200 microgram per 1 ml, Phenylephrine hydrochloride 3.1 mg per 1 ml, Lidocaine hydrochloride 10 mg per 1 ml Mydrane 0.2mg/ml / 3.1mg/ml / 10mg/ml solution for injection 0.6ml ampoules | 20 ampoule P £119.95 4.1 Post-operative pain and inflammation Eye, surgical and peri-operative drug use Ocular peri-operative drugs Drugs used to prepare the eye for surgery, drugs that are injected into the anterior chamber at the time of surgery, and those used after eye surgery, are included here. Cefuroxime p. 1235, administered by intra-ocular injection into the anterior chamber of the eye (intracameral use), is used for the prophylaxis of endophthalmitis after cataract surgery. Non-steroidal anti-inflammatory eye drops such as diclofenac sodium p. 1241, flurbiprofen p. 1242, ketorolac trometamol p. 1242, and nepafenac p. 1224, are used for the prophylaxis and treatment of inflammation, pain, and other symptoms associated with ocular surgery or laser treatment of the eye. Bromfenac p. 1241 is used for the treatment of postoperative inflammation following cataract surgery. Diclofenac sodium and flurbiprofen are also used to prevent miosis during ocular surgery. Apraclonidine p. 1251, an alpha2-adrenoreceptor agonist, reduces intra-ocular pressure possibly by reducing the production of aqueous humour. It is used to control increases in intra-ocular pressure associated with ocular surgery and as short-term treatment to reduce intraocular pressure prior to surgery. Acetylcholine chloride p. 1239, administered into the anterior chamber of the eye during surgery, rapidly produces miosis which lasts approximately 20 minutes. If prolonged miosis is required, it can be applied again. Intra-ocular sodium hyaluronate p. 1233 and balanced salt solution are used during surgical procedures on the eye. Povidone-iodine p. 1238 is used for peri-ocular and conjunctival antisepsis before ocular surgery to support postoperative infection control. Ocular local anaesthetics Oxybuprocaine hydrochloride p. 1241 and tetracaine p. 1241 are widely used topical local anaesthetics. Proxymetacaine hydrochloride p. 1241 causes less initial stinging and is useful for children. Oxybuprocaine hydrochloride or a combined preparation of lidocaine hydrochloride p. 1422 and fluorescein sodium p. 1239 is used for tonometry. Tetracaine produces a more profound anaesthesia and is suitable for use before minor surgical procedures, such as the removal of corneal sutures. It has a temporary disruptive effect on the corneal epithelium. Lidocaine hydrochloride, with or without adrenaline/epinephrine p. 236, is injected into the eyelids for minor surgery. Local anaesthetics should never be used for the management of ocular symptoms. ANAESTHETICS, LOCAL
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Driving and skilled tasks Manufacturer advises patients should be counselled about the effects on driving and skilled tasks.
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0.2 mL for 1 dose, to be injected slowly at the
First-line fragment. Read the complete Indications and Dose section above.
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