Document Detail


Prospective study of sub-Tenon's versus retrobulbar anesthesia for inpatient and day-surgery trabeculectomy.
MedLine Citation:
PMID:  8414420     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Y M Buys; G E Trope
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Ophthalmology     Volume:  100     ISSN:  0161-6420     ISO Abbreviation:  Ophthalmology     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-11-08     Completed Date:  1993-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1585-9     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Toronto Hospital, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
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:
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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