Are ocular injection anesthetic blocks obsolete? Indications and guidelines

Abstract

Sub-Tenon's block should be performed in the operating theatre in preference to retrobulbar or peribulbar anesthesia except for limited indications. When injection ocular block is deemed necessary, we feel that retrobulbar anesthesia with the technique described may be safer than peribulbar anesthesia.

Patient and surgeon comfort in vitreoretinal surgery performed with Sub-Tenon’s Anaesthesia

“…Nevertheless, Retrobulbar block is related to more frequent major complications [ 35 ]; an analysis of 26,045 Sub-Tenon’s and 11,134 Needle Blocks, showed only 4 cases of retrobulbar haemorrhage in the former vs. 8 cases in the latter [ 36 ].…”

Brainstem Anesthesia after Retrobulbar Block: A Case Report and Review of Literature

“…A Cochrane systematic review of RBA versus PBA for cataract surgery also concluded that there is little to choose between the two in terms of anesthesia and akinesia during surgery, measuring acceptability to patients, need for additional injections and development of severe complications (25). Furthermore, since all the above dangers are inherent when using the right needle length and shape with the correct technique, there are advocates for STA over PBA and RBA (26–27). …”

Overview of ocular anesthesia: past and present

“…Sub-tenon's blocks have gained popularity due to the improved safety profile when compared to the 'blind stick' of a retrobulbar injection [15,[19][20][21][22][23]. The technique used today was first described by Stevens [24,25] in 1992.…”