ABSTRACT
Background: Blindness due to cataract presents an enormous problem in terms of human morbidity, economical loss, andsocial burden. Retrobulbar anesthesia was commonly used for cataract surgery. Rare but serious complications led manyophthalmologists to replace retrobulbar with peribulbar anesthesia. However, even peribulbar anesthesia does not eliminatethe serious complications totally. These concerns have led to increased use of blunt needle sub-Tenon’s block over the sharpneedle blocks.Materials and Methods: 200 cases were selected, of which 100 were in the sub-Tenon’s group and the remaining 100 werein the peribulbar group. The efficacy of anesthesia between the two groups was compared in terms of analgesia at variousintervals, akinesia of the globe and eyelids attained after the block. They were graded on a subjective scale and recorded.Minor complications such as chemosis, sub-conjunctival hemorrhage, and rise in increased intraocular pressure (IOP) werealso compared and analyzed.Results: Sub-Tenon’s anesthesia provided better analgesia than peribulbar anesthesia although the akinesia was poorer thanthe latter. Minor complications such as sub-conjunctival hemorrhage were more in sub-Tenon’s group while instantaneous risein IOP was more in peribulbar group. The incidence of chemosis was almost comparable in both the groups.Interpretation and Conclusion: Sub-Tenon’s anesthesia is recommended as a safe and effective alternative to peribulbaranesthesia for small-incision cataract surgery as it provides good analgesia, adequate akinesia, and rare minor complications.
ABSTRACT
PURPOSE: To compare the effects of different volumes of sub-Tenon's anesthetic on intraocular pressure (IOP) and to evaluate the treatment efficacy of vitreoretinal surgery. METHODS: A prospective, clinical trial was conducted on patients undergoing sub-Tenon's anesthesea for vitreoretinal surgery. Patients were randomized to receive either 3 mL, 5 mL or 7 mL of anesthetic solution. IOPs were measured immediately prior to, immediately after, and at 2, 5 and 10 min after the injection. Pain scores were assigned using a numerical visual analogue scale immediately following surgery and again on postoperative day one. RESULTS: A total of 108 patients (119 eyes) were studied, including 35 eyes in the 3 mL group, 48 eyes in the 5 mL group, and 36 eyes in the 7 mL group. There was significant elevation in mean IOP following injection in all groups and a trend toward a larger increase in the group receiving the larger volume (p<0.01). Mean IOPs were elevated immediately after the injections and reduced at all subsequent time intervals. But reduction to the pre-injection level was only achieved in the 3 mL group. There was no significant difference in patient-reported pain scores among the groups when assessed immediately after surgery or on postoperative day one. The incidence of chemosis and high IOP elevation (40 mmHg < or =) was more frequent in the 7 mL group than the other groups (p<0.05). CONCLUSIONS: Sub-Tenon's anesthesia is effective in vitreoretinal surgery. It would appear that a 3-5 mL volume of anesthetic is safe even when complications are considered.
Subject(s)
Humans , Anesthesia , Incidence , Intraocular Pressure , Prospective Studies , Treatment Outcome , Vitreoretinal SurgeryABSTRACT
Se realizó un estudio descriptivo, retrospectivo de 30 pacientes con el diagnóstico de estrabismo que acudieron al Servicio de Oftalmología Pediátrica y Estrabismo del Hospital Oftalmológico Docente "Ramón Pando Ferrer" y fueron operados con la técnica de anestesia subtenoniana desde abril de 2003 hasta mayo de 2004; se analizaron las variables: edad, entidad diagnostica y grado de dolor. Se encontró que el rango de edad que predominó fue de 20 a 39 años, la esotropía como el diagnóstico más frecuente, el grado de dolor fue significativo en la tracción muscular y la técnica anestésica subtenoniana resultó efectiva independientemente de la técnica quirúrgica aplicada, sin complicaciones y con buena analgesia.
A descriptive and retrospective study of 30 patients with the diagnosis of strabismus that were operated on at the Service of Pediatric Ophthalmology and Strabismus of "Ramón Pando Ferrer" Ophthalmological Hospital by the technique of sub-Tenon's anesthesia from April 2003 to May 2004 was conducted.The following variables were analyzed: age, diagnostic entity and pain degree. It was found a predominance of the age range 20-39. Esotropia was the most frequent diagnosis. The pain degree was significant in the muscular traction and the sub-Tenon's anesthetic technique proved to be effective independently of the surgical technique applied, without complications and with good analgesia.