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

Gouveia, Bárbara; Ferreira, Leonardo; Maia, Paula Christianne Gomes Gouveia Souto

doi:10.1155/2022/3838222

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…Compared with general anesthesia, regional anesthesia with MAC provides faster functional recovery, better pain control, and fewer complications, such as intraoperative hypotension. 24 However, studies have shown that two-thirds of patients heard the surgeons talking and that one-third of patients reported objects moving during PPV with MAC. 25 In terms of analgesic eye relaxation and the surgical eye position, the satisfaction of patients and surgeons with regional anesthesia was only one-fourth that with general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Same-Day Cancellation is Higher in Outpatient Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

Chu¹,

Zhang²,

Yue³

et al. 2022

RMHP

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Purpose Safety and efficiency of ambulatory pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) patients is worthy of attention, since patients always have severe systemic diseases. The purpose of this study was to compare the incidence of same-day cancellation of PPV for PDR between outpatients and inpatients and to analyze the causes of cancellations. Patients and Methods This is a retrospective review of consecutive PPV procedures for PDR from January 2019 to April 2021 at either the ambulatory or the inpatient surgery center in an academic tertiary referral center. Data on patient surgery plan, same-day surgical cancellation and follow-up were recorded. Differences in cancellation rate and reasons for cancellation (e.g. medical factors, patient reasons and administrative problems) between outpatients and inpatients were compared. Results In total, 1810 consecutive PPV procedures of 1367 patients were identified; 1509 (83.4%) were managed as inpatient surgeries and 301 (16.6%) as outpatient surgeries. The total same-day cancellation rate was 5.2% for all patients. Although outpatients were younger (51 years vs 52 years, P < 0.001), had less proportion of hypertension (60.5% vs 74.0%), coronary artery disease (10.0% vs 18.8%), renal insufficiency (9.3% vs 18.0%) and cerebrovascular diseases (1.0% vs 11.4%) (all P < 0.001), had less proportion of patients with ASA III status (14.9% vs 27.4%, P < 0.001), and had higher proportion of regional anesthesia with MAC (19.9% vs 5.0%, P < 0.001), the cancellation proportion was significantly higher for outpatients than inpatients (12.3% vs 3.8%, P < 0.001). Overall, the most common reason for surgical cancellation was medical factors, occurring more frequently in outpatients than inpatients (91.9% vs 68.4%, P = 0.012). Conclusion Same-day cancellation is higher in outpatient pars plana vitrectomy for proliferative diabetic retinopathy. To reduce ambulatory surgery cancellations, it is important to strengthen the monitoring of preoperative systemic comorbidities and adjust medication if necessary.

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Section: Discussionmentioning

confidence: 99%

Same-Day Cancellation is Higher in Outpatient Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

Chu¹,

Zhang²,

Yue³

et al. 2022

RMHP

View full text Add to dashboard Cite

show abstract

“…The peribulbar block technique is useful for patients willing to stay for a short time in the hospital. It has many advantages including a low incidence of cough and emesis during the immediate postoperative period (4) .…”

Section: Introductionmentioning

confidence: 99%

Assessing The Efficacy of Single Inferomedial Peribulbar Injection in Lacrimal Intubation Surgery in Adult Patients: A Randomized Clinical Trial

Salem¹,

Mohamed²,

Mahmoud³

2023

The Egyptian Journal of Hospital Medicine

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Background: Inferomedial injection has been suggested as a more comfortable alternative to medial peribulbar block. Aim: We aimed to explore inferomedial injection technique efficacy in minimizing pain during injection as well as intubation compared to the classic medial canthal injection technique during peribulbar block. Methods: This randomized, controlled trial included adult (18 to 70 year-old) patients scheduled for lacrimal intubation surgery. Eligible patients were divided in a random way into two groups. Group 1 (n=24) received inferomedial peribulbar injection using a 25G/ 1" length needle to inject 3 ml of lidocaine: bupivacaine (1: 1) with 30 IU hyaluronidase enzyme to improve the infiltration of the small volume of the local anesthetic drugs. The classic medial canthus injection was applied in Group 2 (n=24) using the same types and amounts of local anesthesia (LA) and the same needle length. The pain was assessed during local anesthetics injection and intubation using the verbal rating scale. Results:In group 1 a low pain score was more frequent than in group 2 (83.3% vs. 16.7%). The median pain score at the LA injection was significantly lower in group 1 (1.0: IQR=1.0-1.0) than in group 2 (2.0: IQR=2.0-2.5). Alternatively, a comparison of the Verbal Rating Scale at intubation revealed comparable results between groups 1 and 2, with no significant differences (p>0.05). Conclusions: Inferomedial LA injection technique is feasible and less painful than the medial canthal injection. Otherwise, both techniques provided adequate intraoperative analgesia during lacrimal intubation and comparable surgeon satisfaction.

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

Cited by 2 publications

References 14 publications

Same-Day Cancellation is Higher in Outpatient Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

Same-Day Cancellation is Higher in Outpatient Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

Assessing The Efficacy of Single Inferomedial Peribulbar Injection in Lacrimal Intubation Surgery in Adult Patients: A Randomized Clinical Trial

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