A Review of Novel Anesthetic Technique for Vitreoretinal Surgery

Abstract

Background and Objective: Currently, there is no standardized formulation of intravenous anesthetic that exists for vitreoretinal surgery. We describe a novel anesthetic protocol for vitreoretinal surgery that is safe and effective for patients and surgeons alike. Study Design: Review the current challenges to vitreoretinal anesthetic technique and descriptive overview outlining the proposed anesthetic protocol and associated experience with technique. Results: The proposed anesthetic technique utilizes a sub-tenon peribulbar block with a continuous propofol infusion. A low dosage continuous propofol infusion provides patients with profound anxiolysis and relaxation while maintaining wakefulness. Fentanyl can be additionally titrated for patients that report symptoms of pain or increased respiratory rate. Conclusion: A low dose propofol infusion in combination with sub-tenon peribulbar block and judicious use of fentanyl provide an ideal operative condition for ambulatory vitreoretinal surgery. [ Ophthalmic Surg Lasers Imaging Retina 2023;54:xx–xx.]