The Ideal Surgical Anaesthesia: A Comparison of Pain Experience in Subjects Undergoing Cataract Surgery Under Topical Versus Subtenon Anaesthesia

Abstract

Background: Recent advancements in cataract surgery and local anaesthesia administration has led to the majority of cataract surgeries been performed under local anaesthesia. This has further intensified the search for the ideal anaesthesia. The use of topical anaesthetic agents in cataract surgeries has brought us closer to finding that ideal anaesthesia. Objective: The objective of this study is to determine the viability of topical anaesthesia as a comparable mode of anaesthesia to subtenon anaesthesia in cataract surgery. Methods: This is a randomized double-blinded placebocontrolled clinical trial. 118 subjects undergoing small incision cataract surgery were allocated to either a topical anaesthesia group (topical anaesthesia with placebo subtenon's injection of balanced salt solution, n=40) or subtenon's group (sub-tenon's anaesthesia with placebo topical balanced salt solution, n=78). Pain experienced during and after the operation was assessed using the numerical rating scale, aided with a visual analogue graphic pain score chart. Results: There was no significant difference in mean pain score between the two groups during anaesthesia administration (P=0.48), during cataract surgery (P=0.37), immediately after surgery (P=0.77) and 30 minutes after surgery (P=0.17). Conclusion: Topical anaesthesia is comparable to subtenon's anaesthesia in patients undergoing cataract surgery.