Hmm, let's see, should I let a nurse anesthetist stick an IV line in my arm — or should I suck on a lemony lozenge?

Easy call for someone like me, who once passed out after giving blood … and fell backward over a chair … and hit my head on an exercise bicycle.

But I digress.

Turns out, it's an easy call as well for patients coming to Dr. Y. Ralph Chu.

The Bloomington ophthalmologist was among the first three doctors in the U.S. this year to try MKO Melt, a lozenge that slowly dispenses non-opioid anesthesia so patients can avoid a painful needle jab. Chu has found it popular and appropriate for about three-fourths of his cataract patients.

Easier anesthesia fits with the broader medical movement toward easier surgeries that can be performed in outpatient settings, Chu said. "There's a trend in surgery to be minimally invasive, have quicker recoveries and have a more comfortable patient experience. We looked at our cataract surgeries and the biggest discomfort for patients was getting the IV placed."

Cataract replacements are common for elderly patients when their natural lenses become clouded and impair vision. A doctor typically makes a small incision to access the lens, which is then broken up with a laser or ultrasound device, then suctioned out and replaced with an implant.

Replacement of both lenses through two procedures is common. Oddly, research has found that patients suffer more pain and anxiety during the second procedures. One reason might be anxiety over receiving second IVs, Chu said, and the lozenge prevents that. However, research also suggests anesthesia might not work as well if a second cataract procedure comes shortly after the first.

"It's a physiological thing," he said. "The body almost has a memory to the anesthesia."

The lozenge is made by Imprimis Pharmaceuticals and compounds three established medications — midazolam, ketamine and ondansetron — to relieve pain and anxiety while minimizing nausea.

(Note: Chu reported no financial relationships with Imprimis.)

The lozenge is more expensive than an IV right now, but Chu said his surgery center is absorbing that cost — an investment that could draw patients who are looking for more comfortable procedures.

"It tastes lemony," Chu said. "Well, they tell me it tastes lemony. I have not tried it."

Jeremy Olson • 612-673-4499