| Prospective study of sub-Tenon's versus retrobulbar anesthesia for inpatient and day-surgery trabeculectomy. | |
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MedLine Citation:
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PMID: 8414420 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Several retrospective studies have demonstrated the safety and efficacy of sub-Tenon's anesthesia in ocular surgery. This is the first prospective randomized study comparing sub-Tenon's versus retrobulbar anesthesia for glaucoma surgery. METHODS: Thirty-nine patients undergoing both inpatient and day surgery trabeculectomy were randomized to receive retrobulbar or sub-Tenon's anesthesia. Retrobulbar anesthesia consisted of a 1.5-ml injection of a 1:1 mixture of 2% lidocaine without epinephrine and 0.5% plain bupivacaine with hyaluronidase. Sub-Tenon's anesthesia consisted of 2% lidocaine without epinephrine injected over the superior, medial and lateral recti muscles. Both groups received a van Lint lid block and a standardized sedative. Outcome parameters evaluated included patient demographics, operative complications, intraoperative and postoperative patient comfort, and volume of anesthetic. RESULTS: Seventeen patients were randomized to the retrobulbar group and 22 to the sub-Tenon's group. Patient discomfort was statistically similar between the groups. There was no statistical difference between groups with respect to quantity of sedative received, surgical exposure, eye movements, or operative complications. A retrobulbar hemorrhage, however, developed at the time of retrobulbar anesthesia in one patient, requiring cancellation of surgery. A larger volume of local anesthetic was required in the retrobulbar group versus the sub-Tenon's group (1.8 versus 1.1 ml; P < 0.01). Patients receiving retrobulbar injections were more likely to require additional anesthesia (P < 0.01) and postoperative analgesics (P < 0.05) compared with patients undergoing sub-Tenon's injection. There was no significant difference between the groups with respect to age, sex, or operated eye. CONCLUSIONS: Sub-Tenon's anesthesia is safe and effective for patients undergoing either inpatient or day-surgery trabeculectomies, and it requires less local anesthetic than retrobulbar anesthesia. |
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Authors:
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Y M Buys; G E Trope |
Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Ophthalmology Volume: 100 ISSN: 0161-6420 ISO Abbreviation: Ophthalmology Publication Date: 1993 Oct |
Date Detail:
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Created Date: 1993-11-08 Completed Date: 1993-11-08 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7802443 Medline TA: Ophthalmology Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1585-9 Citation Subset: IM |
Affiliation:
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Department of Ophthalmology, Toronto Hospital, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Ambulatory Surgical Procedures Anesthesia, Local / methods* Bupivacaine / administration & dosage Female Hospitalization Humans Hyaluronoglucosaminidase / administration & dosage Lidocaine / administration & dosage Male Middle Aged Orbit Postoperative Complications Prospective Studies Tendons Trabeculectomy* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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137-58-6/Lidocaine; 2180-92-9/Bupivacaine; EC 3.2.1.35/Hyaluronoglucosaminidase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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