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Peribulbar Anaesthesia (peribulbar + anaesthesia)
Selected AbstractsThe effect on outcome of peribulbar anaesthesia in conjunction with general anesthesia for vitreoretinal surgeryANAESTHESIA, Issue 3 2010A. M. Ghali Summary The purpose of this study was to evaluate peri-operative outcome after vitreoretinal surgery when peribulbar anaesthesia is combined with general anaesthesia. Sixty adult patients undergoing elective primary retinal detachment surgery with scleral buckling or an encircling procedure received either peribulbar anaesthesia in conjunction with general anaesthesia or general anaesthesia alone. For peribulbar anaesthesia a single percutaneous injection of 5,7 ml of local anaesthetic solution (0.75% ropivacaine with hyaluronidase 15 iu.ml,1) was used. The incidence of intra-operative oculocardiac reflex and surgical bleeding interfering with the surgical field, postoperative pain and analgesia requirements, and postoperative nausea and vomiting were recorded. In the block group there was a lower incidence of oculocardiac reflex and surgical bleeding intra-operatively. Patients in the block group also had better postoperative analgesia and a lower incidence of postoperative nausea and vomiting compared with the group without a block. The use of peribulbar anaesthesia in conjunction with general anesthesia was superior to general anaesthesia alone for vitreoretinal surgery with scleral buckling. [source] A comparison of sub-Tenon's with peribulbar anaesthesia in patients undergoing sequential bilateral cataract surgeryANAESTHESIA, Issue 1 2009M. Budd Summary The aim of this study was to compare efficacy and particularly patient preference of sub-Tenon's anaesthesia with peribulbar anaesthesia in patients undergoing sequential, bilateral, cataract surgery. Fifty patients were randomised to either sub-Tenon's or peribulbar anaesthesia for their first operation and the alternative technique for their subsequent operation. Intra-ocular pressure was measured, globe and lid akinesia were scored, patients completed a visual rating score of injection and operative pain and their preference for anaesthesia was assessed. Intra-ocular pressure rose significantly following peribulbar injection (p = 0.02) but was comparable at 5 min. There was no significant difference in lid or globe movement. Injection and operative pain scores were low and comparable. Both methods provided similar anaesthesia and akinesia. The majority (86%) chose the method they received first irrespective of whether it was sub-Tenon's or peribulbar, but 10% of patients preferred sub-Tenon's, disliking the facial numbness from peribulbar anaesthesia. [source] An audit of peribulbar blockade using 15 mm, 25 mm and 37.5 mm needles, and sub-Tenon's injection,ANAESTHESIA, Issue 8 2004A. A. Van Den Berg Summary The efficacy of peribulbar anaesthesia performed with short, medium and long needles, with sub-Tenon's injection as a control, was audited. Two hundred patients undergoing cataract surgery underwent peribulbar injection using 25G needles of the following lengths: 15 mm, 25 mm or 37.5 mm. Sub-Tenon's injections were performed with a curved 25-mm sub-Tenon anaesthesia cannula. The injection technique, ocular akinesia and analgesia scoring system, and supplementary injection protocols were standardised. After initial injections of local anaesthetic via the sub-Tenon's cannula or with 37.5 mm, 25 mm and 15 mm needles, supplementation was required in one (2%), 13 (26%), 22 (44%) and 32 (64%) of patients, respectively; the total number of supplementary injections required were 1, 16, 35 and 47, respectively. It is concluded that the efficacy of peribulbar anaesthesia depends upon the proximity of the deposition of local anaesthetic solution either to the globe or orbital apex. These data justify the classification of peribulbar anaesthesia into: circum-ocular (sub-Tenon's, episcleral), peri-ocular (anterior, superficial); peri-conal (posterior, deep) and apical (ultra-deep) for teaching purposes. [source] Comparison of a bupivacaine 0.5% and lidocaine 2% mixture with levobupivacaine 0.75% and ropivacaine 1% in peribulbar anaesthesia for cataract surgery with phacoemulsificationACTA OPHTHALMOLOGICA, Issue 8 2007Mehmet Borazan Abstract. Purpose:, To compare a bupivacaine and lidocaine mixture with levobupivacaine and ropivacaine in terms of safety, efficacy and blocking quality in peribulbar anaesthesia for phacoemulsification. Methods:, A total of 105 patients scheduled for cataract surgery with peribulbar anaesthesia were randomly allocated into three groups of 35 patients each, to receive 5 ml of, respectively, a 1 : 1 mixture of bupivacaine 0.5% and lidocaine 2% (group 1), levobupivacaine 0.75% (group 2), or ropivacaine 1% (group 3). Ocular movement scores were evaluated at 2, 4, 6, 8 and 10 mins after injection. Intraoperative and postoperative analgesia were evaluated by verbal pain scores. Duration of surgery, need for supplementary anaesthesia, haemodynamic parameters and the incidence of perioperative complications were recorded. Results:, The ocular movement score in min 2 was significantly lower in group 1. There was no significant difference between groups 2 and 3. Ocular movement scores at mins 4 and 6 were significantly decreased in group 1 and 2 compared with group 3. There was no significant difference among the groups in ocular movement scores at mins 8 and 10. Verbal pain scores in postoperative hour 4 were highest in group 3, but scores for the intraoperative period and postoperative hours 1 and 2 were similar among the groups. Duration of surgery and haemodynamic parameters did not differ among the groups. Conclusions:, All agents were considered to be convenient for clinical use in cataract surgery with peribulbar anaesthesia. Although the ocular movement scores in the ropivacaine group were higher than in the other groups at mins 4 and 6, this did not imply any clinical significance. [source] Topical versus peribulbar anaesthesia for cataract surgeryACTA OPHTHALMOLOGICA, Issue 6 2003Gangolf Sauder Abstract. Background:,To assess and compare the efficacy and safety of topical versus peribulbar anaesthesia in patients undergoing routine cataract surgery. Methods:,The unicentre, prospective, randomized, clinical interventional trial included 140 consecutive patients undergoing routine cataract surgery performed by one of two surgeons. The patients were randomly distributed to either peribulbar anaesthesia or topical anaesthesia. To assess intraoperative pain, each patient was asked immediately after surgery to quantitate his/her pain using a 10-point pain rating scale. Results:,The study groups did not differ significantly in pain score (p = 0.54), duration of surgery (p = 0.52), anaesthesia-related intraoperative difficulties (p = 0.17), postoperative visual acuity (p = 0.94), overall intraoperative surgical complication rate, blood pressure rise (p = 0.16) or blood oxygen saturation (p = 0.74) Conclusions:,Patient comfort and surgery-related complications did not differ between topical anaesthesia and peribulbar anaesthesia. As there are no significant differences between the two techniques in terms of subjective pain experienced by patients, intraoperative complications and postoperative visual outcome, and in view of the minimally invasive character of topical anaesthesia compared to peribulbar anaesthesia, the present study suggests the use of topical anaesthesia for routine cataract surgery. [source] | ||||||||||