Peribulbar versus general anesthesia for horizontal strabismus surgery

Carvalho, Keila Monteiro de; Millán, Tatiana; Minguini, Nilza; Wakamatsu, Tais Hitomi

doi:10.1590/s0004-27492008000300009

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Authors reported no morbidity and only one patient required an additional injection of anesthesia to achieve adequate anesthesia. Carvalho et al 49 showed no difference between the postoperative results of strabismus surgery under peribulbar and general anesthesia in small and moderate angle of horizontal strabismus.…”

Section: Discussionmentioning

confidence: 96%

Peribulbar anesthesia for strabismus surgery in adult patients

Vagge

Marenco

et al. 2020

European Journal of Ophthalmology

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Purpose: To evaluate the efficacy and safety of peribulbar anesthesia during strabismus surgery. Methods: Medical records of patients undergoing strabismus surgery and peribulbar anesthesia were reviewed. The overall efficacy of peribulbar anesthesia was evaluated as requirement of supplemental peribulbar anesthesia, impossibility to perform eye muscles surgery due to inadequate efficacy of the block and peribulbar block complications that occurred up to 6 weeks postoperatively. Presence of oculocardiac reflex (OCR) and presence of decreased visual acuity and afferent pupillary defect postoperatively were reported. Results: A total of 510 patients comprised our study group. The total amount of peribulbar injections was 717. Four patients (0.7%) required supplemental injection in the superonasal quadrant. Five of 510 (0.9%) required an anesthesiologic intervention with intravenous atropine. Eighty patients of 510 (15.6%) complained about transitory complete ptosis and/or amaurosis postoperatively. No complications were observed up to 6 weeks postoperatively. Conclusion: Peribulbar anesthesia was an effective and safe option during strabismus surgery in adult patients.

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Section: Discussionmentioning

confidence: 96%

Peribulbar anesthesia for strabismus surgery in adult patients

Vagge

Marenco

et al. 2020

European Journal of Ophthalmology

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“…Beside chemosis that spontaneously reversed, we did not find any other type of complications associated with peribulbar block, such as optic nerve damage, hemorrhage, or eye perforation [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Approach in Ambulatory Vitrectomy: Peribulbar Block vs. Balanced General Anesthesia

Gouveia

Ferreira

Maia

2022

Anesthesiology Research and Practice

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Background. Vitrectomy is one of the most common outpatient ophthalmic surgeries. The anesthetic technique used in outpatient surgery should contribute to a faster functional recovery, better pain control, and fewer complications. The aim of this study was to compare peribulbar block and balanced general anesthesia, in patients undergoing outpatient vitrectomy. Methods. A prospective cohort study was carried out, including adult patients undergoing ambulatory vitrectomy, between January and February 2018. Peribulbar block or balanced general anesthesia was the independent variable analyzed. Clinical and perioperative variables were evaluated, namely, postoperative pain, nausea, and vomiting in the postoperative period, intraoperative hypotension, patient satisfaction with the anesthetic technique, time to oral diet introduction and to hospital discharge, operating room occupancy time, and pharmacological costs. SPSS® 27 was used for statistical analyses. Results. Twenty-one patients were evaluated, 11 of whom underwent peribulbar block and 10 underwent balanced general anesthesia. Patients undergoing peribulbar block did not experience postoperative pain when compared to patients undergoing balanced general anesthesia ( p = 0.001 ). Intraoperative hypotension occurred in 18.2% of patients undergoing peribulbar block and in 70% of those undergoing balanced general anesthesia ( p = 0.03 ). Time to oral diet introduction (<1 hour vs. > 2 hours; p < 0.05 ), operating room occupancy time (70 vs. 90 minutes; p = 0.027 ), time to hospital discharge (17 vs. 22.5 hours; p = 0.004 ), and pharmacological costs (4.65 vs. 12.09 euros; p < 0.05 ) were lower in patients undergoing peribulbar block versus balanced general. Conclusions. Peribulbar block seems to meet the criteria of an ideal anesthetic technique in outpatient vitrectomy surgery.

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“…Other than muscle reattachment to the sclera with sutures, scleral perforation can also occur during peribulbar or retrobulbar injections [8]- [10]. Peribulbar anesthesia has been reported with fewer risks of ocular complications due to short needle presented, though presumed to be safer than retrobulbar injection, is not without risk of this complication.…”

Section: Discussionmentioning

confidence: 99%

“…Peribulbar anesthesia has been reported with fewer risks of ocular complications due to short needle presented, though presumed to be safer than retrobulbar injection, is not without risk of this complication. This is particularly important in myopic eyes due to thinned sclera and increased axial length [10]. Indirect ophthalmoscopy is necessary to identify any retinal changes indicative of a penetration or perforation.…”

Section: Discussionmentioning

confidence: 99%

Ocular Complications of Strabismus Surgery

Yurdakul¹,

Koç²

2014

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Background: To evaluate ocular complications of strabismus surgery at the Department of Strabismus and Neuroophthalmology in our clinic. Methods: The medical records of patients who underwent strabismus surgery between March 1999 and February 2013 were retrospectively reviewed. Patients with minor ocular complications such as wound irregularities, conjunctivitis, subconjunctival hemorrhage, and less than six-month follow-up periods were excluded from the study. Employed strabismus surgeries included recessions, resections, muscle advancements, inferior oblique myectomies, and muscle transpositions. Results: Our case series are comprised of 1468 patients who underwent strabismus surgery. The ages of the patients ranged from 6 to 80 years. Recognized primary ocular complications were noted in eight patients (0.5%). Scleral perforation with retinal break was observed in one myopic patient during retrobulbar anesthesia. Medial rectus rupture occurred during medial rectus recession in one patient with chronic complete sixth nerve palsy. Conjunctival cyst occured postoperatively in one patient with partially refractive accommodative esotropia who had bilateral medial rectus recession. Corneal dellen developed postoperatively in five patients with exotropia. Conclusion: Ocular complications of strabismus surgery are usually treatable. Damage to ocular structures can be prevented by meticulous surgical approach. Close postoperative follow-up is required in all cases.

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Peribulbar versus general anesthesia for horizontal strabismus surgery

Cited by 6 publications

References 13 publications

Peribulbar anesthesia for strabismus surgery in adult patients

Peribulbar anesthesia for strabismus surgery in adult patients

Anesthetic Approach in Ambulatory Vitrectomy: Peribulbar Block vs. Balanced General Anesthesia

Ocular Complications of Strabismus Surgery

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