A sub-Tenon's capsule injection of lidocaine induces extraocular muscle akinesia and mydriasis in dogs

The effect of local anaesthetic on the extraocular muscles was investigated in dogs by injecting lidocaine into the space between Tenon's capsule and the sclera. A cross-over design was used with both eyes from five Beagle dogs randomly injected, under general anaesthesia, with 1 mL of 2% lidocaine (1 mL-lidocaine group), 2 mL of 2% lidocaine (2 mL-lidocaine group) or 2 mL of normal saline (control group). Each eye was assigned to all treatments with a minimum 14 day interval between injections. Changes in eye position, pupil diameter, and intraocular pressure (IOP) were evaluated during the procedure.All eyes in the 2 mL-lidocaine group exhibited akinesia and mydriasis (pupil diameter >10 mm) with an onset time of 6.5 ± 4.9 and 4.2 ± 4.3 min, respectively. In the 1 mL-lidocaine group, akinesia was induced in nine eyes and mydriasis occurred in seven eyes at 10.7 ± 5.8 and 5.4 ± 2.4 min after the injection, respectively. No changes in eye position or pupil diameter were observed in the control group. Akinesia was maintained for 44.3 ± 26.7 min in the 1 mL-lidocaine group and for 88.5 ± 17.2 min in the 2 mL-lidocaine group. Duration of mydriasis was 51.7 ± 28.9 min in the 1 mL-lidocaine group and 82.9 ± 15.6 min in the 2 mL-lidocaine group. Marked chemosis and sub-conjunctival haemorrhage occurred in 16/30 and 15/30 eyes, respectively. No significant change in IOP was observed between the mean pre- and post-injection values in all groups. These results suggest that a sub-Tenon's injection of 2 mL of 2% lidocaine provided effective extraocular muscle akinesia and mydriasis in dogs.