Circumferential Subconjunctival Anesthesia Versus Retrobulbar Anesthesia for Extracapsular Cataract Extraction

Tulvatana, Wasee; Kulvichit, Kittisak; Tinnungwattana, Uraiwan

doi:10.1213/01.ane.0000215125.07562.eb

Cited by 3 publications

(2 citation statements)

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“…Posterior capsular tear with vitreous loss occurred in three of 75 patients (5.3%) in the subconjunctival group, which is similar to the 5.01% rate reported previously 9. Anesthetic complications such as localized subconjunctival hemorrhage are also more common when using this technique, which is in agreement with the results of Tulvatana et al7 The successful use of circumcorneal perilimbal anesthesia in extracapsular cataract surgery, and circumferential subconjunctival anesthesia and superior subconjunctival anesthesia with deep topical anesthesia has been reported 7,11,12. We used superior subconjunctival anesthesia, which permits the surgeon to perform procedures such as bridle suturing, subconjunctival peritomy, cautery, and wound construction.…”

Section: Discussionsupporting

confidence: 88%

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Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: a randomized controlled trial

Kongsap¹

2012

OPTH

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PurposeTo evaluate the effectiveness of subconjunctival anesthesia as compared to retrobulbar anesthesia for pain control during manual small-incision cataract surgery (MSICS) performed by third-year residents.DesignA randomized, controlled trial.Patients and methodsA total of 150 patients undergoing routine cataract surgery were randomly assigned to receive either subconjunctival anesthesia (group 1, n = 75) or retrobulbar anesthesia (group 2, n = 75). Third-year residents performed MSICS using the modified Blumenthal technique. Subconjunctival anesthesia was administered by injecting 2% xylocaine with adrenalin into the superior conjunctiva, and retrobulbar anesthesia by injecting 2 mL of 2% xylocaine with adrenalin into the retrobulbar space. We studied the following variables: intraoperative pain score rated on a 100-point visual analog scale (VAS), operative time, and injection and operative complications.ResultsA mean age of 69 vs 70 years, an operative time of 47.1 (SD, 9.9) min vs 47.7 (10.9) min, and a median (interquartile range) pain score of 40 (range, 20–70) vs 40 (range, 20–50) were observed in the subconjunctival and the retrobulbar groups, respectively. The injection complication of subconjunctival hemorrhage was significantly higher in the subconjunctival group (25.3%) compared to the retrobulbar group (1.3%). The operative complication rate between groups was not different (P > 0.05).ConclusionBoth, superior subconjunctival anesthesia and retrobulbar anesthesia were effective during MSICS when used in a residency training program.

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Section: Discussionsupporting

confidence: 88%

“…Superior subconjunctival anesthesia produces adequate analgesia, but not adequate akinesia. Its use has been reported in conventional extracapsular cataract surgery to avoid serious complications associated with other methods of anesthesia 7. We propose that MSICS can be performed under subconjunctival anesthesia.…”

Section: Introductionmentioning

confidence: 99%