Comparison of pain experience during 23-G vitreoretinal surgery under topical and retrobulbar anesthesia

Mete, Alper; Saygılı, Oğuzhan; Kimyon, Sabit; Pamukcu, Can; Çeri, Seda; Güngör, Kıvanç; Temizer, Mithat

doi:10.1007/s10792-016-0268-6

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…Regarding retrobulbar local anesthesia we had to wait for at least 10 to 20 minutes before the effect of anesthesia was achieved, whereas in case of topical local anesthesia, the onset was rapid and we could start surgery immediately. This clearly saves the time of surgeon [13][14][15] .…”

Section: Discussionmentioning

confidence: 88%

Efficacy of Retrobulbar versus Topical Anesthesia in Cataract Surgery

Munir¹,

Arshad²,

Nazir³

et al. 2022

PJMHS

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Aim: To monitor the effect of retrobulbar versus topical anesthesia in cataract surgery patients by comparing different parameters such as: intraocular pressure akinesia and analgesia parameters. Study type: Interventional case series. Place and duration of study: Department of Ophthalmology, Niazi Medical & Dental College Sargodha from 1st October 2020 to 31st October 2021. Methodology: One hundred patients who underwent cataract surgery were enrolled. Study participants were divided into two groups and each group contain fifty 50 participants. Group one give retrobulbar block and group two treated by topical anesthesia. Complete ocular and systematic examinations and relevant examinations like clotting time, blood pressure, blood sugar, complete blood examination and bleeding time were done before starting the surgery. Results: 80% were males and 20% were females. During topical local anesthesia, 47(94%) patients experienced pain free surgery whereas in retrobulbar anesthesia, only 38(76%) patients experienced pain free surgery. In retrobulbar anesthesia group, complete akinesia was observed in 25(50%) patients. In retrobulbar group, significant increase in intraocular pressure was noted 41(82%) upto 30 mmHg after the administration of local anesthesia as compared to topical anesthesia group. Conclusion: Topical anesthesia is more safe and effective approach for cataract patients in contrast to retrobulbar group. It prevents many life and sight threatening implications like globe perforation and brain stem anesthesia. Key words: Efficacy, Retrobulbar, Topical anesthesia, Surgery

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Section: Discussionmentioning

confidence: 88%

Efficacy of Retrobulbar versus Topical Anesthesia in Cataract Surgery

Munir¹,

Arshad²,

Nazir³

et al. 2022

PJMHS

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“…The initial electronic database search yielded 1501 articles after removal of duplicates, with 36 studies selected for full-text review (see Figure 1 for a PRISMA flow diagram). Excluded were 3 non-RCTs, 6,10,11 6 not full-length articles, 12 –17 1 article published before 1990, 18 16 studies with vitreoretinal surgery for other causes than retinal detachment, 19 –34 and 2 articles without vitreoretinal surgery. 35,36 The 8 remaining articles were included in this systemic review.…”

Section: Resultsmentioning

confidence: 99%

Postoperative Pain Management in Vitreoretinal Surgery for Retinal Detachment: A Systematic Review of Randomized Controlled Trials

Massicotte

Hammamji

Landry

et al. 2018

Journal of VitreoRetinal Diseases

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The purpose of this study is to examine the evidence for postoperative pain management in patients undergoing vitreoretinal surgery for retinal detachment by systematic review. Methods: A systematic review of the literature was performed using multiple databases in July 2016 and September 2017. Two independent reviewers screened titles and abstracts and analyzed selected papers in detail. Included studies assessed patients undergoing vitreoretinal surgery for retinal detachment and described postoperative pain management. Risk of bias was assessed using the criteria outlined in the "risk of bias" tool in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Nine randomized controlled studies comprising 517 patients met the inclusion criteria. Pain management included perioperative peribulbar, sub-Tenon, and retrobulbar anesthetic block; perioperative systemic anti-inflammatory and postoperative systemic and topical anti-inflammatory drugs; and ice compress. Pain scores were assessed with nominal, numerical, and visual analog scales. Risk of bias was low for 2 studies, unclear for 4 studies, and high for 3 studies. All studies reported better postoperative pain scores with the active treatment group except for a single study comparing retrobulbar chirocaine with and without clonidine. No serious adverse events were reported for any of the studies. Conclusion: Heterogeneity of studies did not allow for meta-analysis, but qualitative analysis suggests that pain relief can be achieved in the short term with a variety of treatment interventions. Additional study is required to specifically examine pain management strategies according to the characteristics of the anesthesia and surgery as well as the needs of the patient.

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“…There are several reports of vitreoretinal surgery and combined phacoemulsification vitrectomy being performed under topical anesthesia [16, 21, 27-30]. Yepez et al [16, 17] reported that topical anesthesia, combined with neuroleptic anesthesia, was a safe and effective alternative to peribulbar or retrobulbar anesthesia in posterior vitrectomy procedures.…”

Section: Discussion/conclusionmentioning

confidence: 99%

A New Two-Step Anesthesia for 23- or 25-Gauge Vitrectomy Surgery: A Prospective, Randomized Clinical Trial

et al. 2020

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Objective: To investigate the safety and efficacy of topical anesthesia combined with subconjunctival anesthesia (termed two-step anesthesia) for 23- or 25-gauge pars plana vitrectomy or other posterior segment surgery. Methods: Patients (n = 90) requiring 23-/25-gauge vitrectomy or other posterior segment surgery were randomized into 3 groups. Group 1 received peribulbar anesthesia, group 2 received retrobulbar anesthesia and group 3 received two-step anesthesia. A 5-point visual analog pain scale (VAPS) was used to measure self-report of patient pain. Complications were recorded for subsequent analysis. Results: VAPS scores for overall intraoperative pain ranged from 0 to 3 (1.07 ± 1.07) in group 1, from 0 to 2 (0.69 ± 0.93) in group 2 and from 0 to 3 (1.06 ± 0.98) in group 3. Assessment of surgeon discomfort score ranged from 0 to 2 (0.31 ± 0.66) in group 1, from 0 to 3 (0.38 ± 0.82) in group 2 and from 0 to 2 (0.47 ± 0.62) in group 3. Both scores reveal no significant difference among the 3 groups. While there were no complications noted in group 1, there was an ocular perforation in group 2. Additionally, there were no complications in group 3 related to the anesthetic technique. Conclusions: Results suggest that two-step anesthesia is a safe and effective anesthetic approach for selected patients undergoing 23- or 25-gauge pars plana vitrectomy or other posterior segment surgeries. It may offer a viable alternative to peribulbar anesthesia and retrobulbar anesthesia for carefully selected 23- or 25-gauge cannular-access ocular surgeries.

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Comparison of pain experience during 23-G vitreoretinal surgery under topical and retrobulbar anesthesia

Cited by 6 publications

References 29 publications

Efficacy of Retrobulbar versus Topical Anesthesia in Cataract Surgery

Efficacy of Retrobulbar versus Topical Anesthesia in Cataract Surgery

Postoperative Pain Management in Vitreoretinal Surgery for Retinal Detachment: A Systematic Review of Randomized Controlled Trials

A New Two-Step Anesthesia for 23- or 25-Gauge Vitrectomy Surgery: A Prospective, Randomized Clinical Trial

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