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Br J Ophthalmol 2002;86:524-526 doi:10.1136/bjo.86.5.524
  • Scientific correspondence

An evaluation of the administration of sub-Tenon local anaesthesia by a nurse practitioner

  1. H Waterman1,
  2. S Mayer2,
  3. M J Lavin2,
  4. A F Spencer2,
  5. C Waterman3
  1. 1School of Nursing, Midwifery and Health Visiting, University of Manchester
  2. 2Manchester Royal Eye Hospital
  3. 3Manchester School of Management, UMIST
  1. Correspondence to: Dr Heather Waterman, School of Nursing, Midwifery and Health Visiting, Coupland III, University of Manchester, Oxford Road, Manchester M13 9PL, UK; heather.waterman{at}man.ac.uk
  • Accepted 28 November 2001

Abstract

Aim: To evaluate the administration of sub-Tenon local anaesthesia (LA) by a nurse practitioner.

Methods: 106 consecutive patients listed for cataract surgery were given sub-Tenon's anaesthesia by a nurse practitioner. The surgical procedure was performed within 15 minutes of the administration of the LA. Pain, state and adequacy of anaesthesia, appearance of the eye, and patient anxiety were measured. Patients' experiences of this new nursing role were gained through interview.

Results: At the beginning of surgery, few patients showed eye movement in any of the four quadrants and the surgeons reported that akinesia was inadequate in only seven (7.1%) cases. Three patients (3.3%) gave a pain score of 3 out of 10 or above during surgery whereas the surgeons assessed the pain relief to be inadequate in eight (8.1%) cases. Five (5.3%) patients required a top up of anaesthesia and 51 (39.8%) patients developed conjunctival chemosis in two or more quadrants. Overall, patients' comments indicate that they were pleased with the new service.

Conclusion: The results suggest that nurse practitioner delivered sub-Tenon LA is an effective and safe method of LA administration for cataract surgery.

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