Anestesia tópica más subconjuntival versus retrobulbar en la esclerectomía profunda no penetrante

Abstract

RESUMENObjetivo: Comparar la eficacia y seguridad de la anestesia tópica-subconjuntival con la retrobulbar en la escleroctomía profunda no penetrante suplementada con 5-FU. Método: Se realizó un estudio prospectivo y aleatorizado de 30 pacientes consecutivos a los que se les practicó anestesia tópica-subconjuntival (n=14) o retrobulbar (n=16). Se evaluaron las condiciones operatorias, el confort del paciente, el dolor postoperatorio, el dolor total y el resultado quirúrgico en cuanto a bajada de presión intraocular. Resultados: No hubo diferencias en las condiciones quirúrgicas entre ambos grupos. El grupo con anestesia retrobulbar refirió más dolor durante la aplicación del anestésico (P= 0,00). El grupo con anestesia tópica-subconjuntival refirió más disconfort intraoperatoriamente (P=0,00). Sin embargo, esto no representó un problema para el cirujano. No hubo diferencias en el dolor postoperatorio entre ambos grupos. No hubo diferencias estadísticamen-te significativas en cuanto al dolor total. No hubo ARTÍCULO ORIGINAL ABSTRACT Purpose: To compare the safety and efficacy of topical plus subconjunctival versus retrobulbar anesthesia for primary non-penetrating sclerectomy supplemented with adjuntive 5-FU. Methods: A prospective study of 30 consecutive patients who were randomized to receive subconjunctival (n = 14) or retrobulbar (n = 16) anesthesia was performed. Operating conditions, patient comfort, postoperative pain, total pain and surgical outcomes were evaluated. Results: There were no differences in the operating conditions. The retrobulbar group reported significantly more pain during administration of the anesthetic agent than the subconjunctival group (P= 0.00). The subconjunctival group reported more discomfort during surgery than the retrobulbar group (P= 0.00); however, this feature was not a problem for the surgeon. No statistically significant differences were found in regard to the total pain experienced, the postoperative pain, nor the success rates of the operative procedure in either group.

Topical anesthesia versus topical and subconjunctival anesthesia combined in diabetic retinopathy photocoagulation

“…The available literature is mainly focused on comparing the efficiency and safety of different laser devices and the effectiveness of new laser technologies. 1,2,4,11 At the same time, most of the research in ophthalmic analgesia was focused on the efficacy and safety of different anesthetic procedures and drugs for surgical procedures, particularly cataract surgery, 12,13,14 glaucoma surgery 15,16 or during vitreoretinal treatments. 17,18 The present study offered insights into the analgesia techniques for PRP by comparing topical anesthesia with a combined approach using topical and subconjunctival anesthetic injection.…”

Preoperative Preparation and Anesthesia for Trabeculectomy

“…Other studies have found no difference in outcome, when comparing subconjunctival LA and Ga 54 55 and subconjunctival vs Topical, 58 or subconjuctival vs retrobulbar (non-penetrating surgery). 56 A recent review article on ‘modern filtration surgery’ concluded that ‘subconjunctival anesthesia is safe’. 59 …”

“…Most reported IOP at 1 year. These prospective randomized trials have failed to show any difference in trabeculectomy success rate when comparing―subconjunctival vs retrobulbar (non-penetrating surgery), 56 subconjunctival vs topical, 58 or peribulbar vs topical (phacotrabeculectomy). 57 Current evidence indicates no major effect of anesthesia technique on the level of IOP after trabeculectomy.…”