87951
document
One quadrant sub-Tenon 's capsule anesthesia in anterior segment surgery . Reports of complications associated with local anesthesia in ophthalmic surgery have increased conspicuously in recent years . Sub-Tenon 's capsule anesthesia for anterior segment surgery avoids the risks of retrobulbar and peribulbar injections . This study compared sub-Tenon 's and retrobulbar anesthesia . Patients undergoing various anterior segment surgery were randomly assigned to sub-Tenon 's or retrobulbar anesthesia ; 300 were operated with 1-quadrant sub-Tenon 's anesthesia ( 1-QST ) and the results were compared with 270 patients operated with retrobulbar anesthesia . Retrobulbar anesthesia consisted of a 2.5 ml injection of a 1:1 mixture of 2 % lidocaine without epinephrine and 0.5 % bupivacaine . Sub-Tenon 's anesthesia involved direct transconjunctival infiltration of the same local anesthetic directly into the sub-Tenon 's space , in the inferior-nasal quadrant , using a blunt 23-gauge cannula . Patients undergoing various anterior segment surgery procedures were randomly assigned to 1-QST or retrobulbar anesthesia ; 300 patients were operated with 1-QST and the results were compared with 270 patients operated with retrobulbar anesthesia . Preinjection mean ( +/- SD ) IOP wer 12.9 +/- 3.7 mmHg in the retrobulbar and 13.4 +/- 3.2 mmHg in the 1-QST patients . Preoperative intraocular pressures were 8.7 +/- 3.0 mmHg in the retrobulbar and 9.2 +/- 3.2 mmHg in 1-QST patients . Pre- and postinjection IOP for retrobulbar and 1-QST patients were similar . Pain scores for delivery of the anesthetic , using a numerical rating scale , produced a median score of 1 for 1-QST and 2 for the retrobulbar technique . For the subsequent operative procedure , the median score was 1 for 1-QST and 2 for the retrobulbar patients . Complete akinesia was achieved in 41 % with 1-QST and in 69 % of retrobulbar patients . 1-QST patients with incomplete akinesia most often had lateral muscle function which did not interfere with the operation . We found the use of a blunt cannula to deliver anesthetic into the sub-Tenon 's space as a simple , safe and effective alternative approach to traditional retrobulbar anesthesia in anterior segment surgery .
87952
Intervention_Pharmacological
One quadrant sub-Tenon 's capsule anesthesia
87953
Intervention_Pharmacological
Sub-Tenon 's capsule anesthesia
87954
Intervention_Pharmacological
sub-Tenon 's
87955
Intervention_Pharmacological
retrobulbar anesthesia .
87956
Intervention_Pharmacological
sub-Tenon 's or retrobulbar anesthesia
87957
Intervention_Pharmacological
1-quadrant sub-Tenon 's anesthesia ( 1-QST )
87958
Intervention_Pharmacological
retrobulbar anesthesia
87959
Intervention_Pharmacological
Retrobulbar anesthesia
87960
Intervention_Pharmacological
lidocaine without epinephrine and 0.5 % bupivacaine
87961
Intervention_Pharmacological
Sub-Tenon 's anesthesia
87962
Intervention_Pharmacological
1-QST
87963
Intervention_Pharmacological
retrobulbar anesthesia
87964
Intervention_Pharmacological
retrobulbar
87965
Intervention_Pharmacological
1-QST
87966
Intervention_Pharmacological
retrobulbar
87967
Intervention_Pharmacological
1-QST
87968
Intervention_Pharmacological
retrobulbar
87969
Intervention_Pharmacological
1-QST
87970
Intervention_Pharmacological
retrobulbar
87971
Intervention_Pharmacological
1-QST
87972
Intervention_Pharmacological
1-QST
87973
Intervention_Pharmacological
1-QST
87974
Intervention_Pharmacological
retrobulbar anesthesia
87975
Outcome_Physical
Preinjection mean ( +/- SD ) IOP
87976
Outcome_Physical
Preoperative intraocular pressures
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Outcome_Physical
Pre- and postinjection IOP
87978
Outcome_Pain
Pain scores for delivery of the anesthetic
87979
Outcome_Physical
Complete akinesia
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Outcome_Physical
incomplete akinesia
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Outcome_Physical
lateral muscle function
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Participant_Condition
anterior segment surgery
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Participant_Condition
ophthalmic surgery
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Participant_Condition
anterior segment surgery
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Participant_Sample-size
300
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Participant_Condition
1-quadrant sub-Tenon 's anesthesia ( 1-QST )
87987
Participant_Sample-size
270 patients
87988
Participant_Condition
retrobulbar anesthesia
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Participant_Condition
anterior segment surgery