Parabulbar anesthesia for primary vitreoretinal surgery

Ophthalmology. 1997 Mar;104(3):425-8. doi: 10.1016/s0161-6420(97)30297-8.

Abstract

Purpose: The efficacy and safety of parabulbar anesthesia was investigated prospectively in 100 patients undergoing primary vitreoretinal surgery.

Methods: The technique involved three steps: (1) orbicularis oculi injection, (2) subconjunctival injection, and (3) sub-Tenon irrigation. The effect of anesthesia was graded 0 to 5 depending on inadequate anesthesia-akinesia with or without local supplementation. Ninety-three patients underwent vitrectomy without buckling and 4 with an encircling band; 3 had scleral buckling. Mean duration of surgery was 89.38 minutes.

Results: In 69% of patients (grades 4 and 5), no supplementation was required and in 31% (grades 1-3), local supplementation was needed for inadequate anesthesia or akinesia or both. No ocular or systemic complication occurred. Early onset of anesthesia correlated with adequate anesthesia throughout the procedure (P < 0.04).

Conclusions: Parabulbar anesthesia is a safe and effective technique of local anesthesia in patients undergoing primary vitreoretinal surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local / methods*
  • Anesthetics, Local / administration & dosage
  • Bupivacaine / administration & dosage
  • Drug Combinations
  • Female
  • Humans
  • Injections
  • Lidocaine / administration & dosage
  • Male
  • Middle Aged
  • Orbit
  • Prospective Studies
  • Retinal Detachment / surgery*
  • Safety
  • Scleral Buckling*
  • Vitrectomy*
  • Vitreoretinopathy, Proliferative / surgery*

Substances

  • Anesthetics, Local
  • Drug Combinations
  • Lidocaine
  • Bupivacaine