Comparison of Topical Anesthesia and Peribulbar Anesthesia for 23-Gauge Vitrectomy Without Sedation

Mahajan, Deepankur; Sain, Siddarth; Azad, Shorya Vardhan; Arora, Tarun; Azad, Rajvardhan

doi:10.1097/iae.0b013e31827ced51

Cited by 20 publications

(30 citation statements)

References 40 publications

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“…Topical anesthesia essentially eliminates the risk of needle-related complications associated with the injection of local anesthesia. Therefore, the safety and efficacy of the topical anesthesia have been investigated for small-gauge vitrectomy, and have been demonstrated to be safe and effective [8, 9, 12, 13]. However, to best of our knowledge, no study on the safety and efficacy of the topical anesthesia for 27-gauge PPV was reported.…”

Section: Discussionmentioning

confidence: 99%

“…Yepez et al and Bahcecioglu et al also used operative sedation for topical anesthesia patients [6, 7, 14]. Mahajan et al used a serial topical anesthesia method, i.e., proparacaine hydrochloride drops, lignocaine gel for 1 min, another proparacaine hydrochloride infiltration with swab for 1 min [8]. Celiker et al used proparacaine hydrochloride drops 15 min preceding surgery, and then proparacaine hydrochloride infiltration with sponges for another 15 min [9].…”

Section: Discussionmentioning

confidence: 99%

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A comparison between topical and retrobulbar anesthesia in 27-gauge vitrectomy for vitreous floaters: a randomized controlled trial

Zhang

Zhong

et al. 2018

BMC Ophthalmol

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BackgroundTo compare the safety and efficacy of topical anesthesia versus retrobulbar anesthesia in 27-gauge pars plana vitrectomy (PPV) for vitreous floaters.Methods30 patients with vitreous floaters were randomized into Group T (topical anesthesia, proparacaine eye drop) and Group R (retrobulbar anesthesia), and underwent 27-gauge PPV. A 5-point visual analogue pain scale (VAPS) was used to assess patients’ pain experience of anesthesia and surgery procedure (during surgery, 2 h and 1 day after surgery).ResultsThe VAPS of anesthesia procedure was 1.27 ± 0.59 for patients in Group R, while it was all 0 for patients in Group T (p < 0.001). There was no significant difference for VAPS during surgery (Group T: 1.13 ± 0.74, Group R: 0.67 ± 0.62, p = 0.67), 2 h (Group T: 0.80 ± 1.01, Group R: 0.67 ± 0.62, p = 0.67) and 1 day (Group T: 0.20 ± 0.41, Group R: 0.27 ± 0.46, p = 0.68) after surgery between these two groups. Only one patient (6.7%) in Group T required additional topical anesthesia during the surgery. Most of the patients reported the pain experience came from initial trocar insertion in both groups. None of the patients required post operative analgesia in both groups. No intraoperative or postoperative complications were noted in both groups.ConclusionThis study suggested that topical anesthesia is a safe and effective anesthetic approach for patients with floaters who underwent 27-gauge PPV.Trial registrationClinicalTrials.gov NCT03049163. Registered 8 February 2017.Electronic supplementary materialThe online version of this article (10.1186/s12886-018-0838-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A comparison between topical and retrobulbar anesthesia in 27-gauge vitrectomy for vitreous floaters: a randomized controlled trial

Zhang

Zhong

et al. 2018

BMC Ophthalmol

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“…After draping, speculum was inserted and one drop of anesthetic was administered and surgical procedure was begun. Anesthetic status was controlled by grasping the bulbar conjunctiva with colibri forceps [13]. One drop of anesthetic was applied every 30 minutes during the procedure.…”

Section: Methodsmentioning

confidence: 99%

“…Yepez et al have shown that topical anesthesia combined with neuroleptic anesthesia was also safe and effective alternative to peribulbar or retrobulbar anesthesia in posterior vitrectomy procedures with 20 G technique with scleral buckling procedures [6]. There are also reports in the literature with topical technique with 23 G technique [12, 13]. One of them reported comparison of topical anesthesia and peribulbar anesthesia for 23 G posterior vitrectomy [13].…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Topical or Retrobulbar Anesthesia for 23-Gauge Posterior Vitrectomy

Çeliker

Karabaş

Şahin

2014

Journal of Ophthalmology

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Background. To compare the efficacy and safety of topical anesthesia versus retrobulbar anesthesia in 23-gauge vitreoretinal surgery. Materials and Methods. A total of 63 patients scheduled for 23 G posterior vitrectomy without scleral buckling procedures were included in the study. The patients were randomly assigned to receive either topical (Group 1, n = 31) or retrobulbar anesthesia (Group 2, n = 32). Postoperatively, patients were shown a visual analogue pain scale (VAPS) from 1 (no pain or discomfort) to 4 (severe pain or discomfort) to rate the levels of pain. Results. There was more discomfort in patients in Group 2 while anesthetic was administered (Group 1: 1.0 ± 0, Group 2: 2.3 ± 0.7, P = 0.0001). Between the two groups the level of pain during surgery (Group 1: 1.4 ± 0.5, Group 2: 1.5 ± 0.5; P = 0.85) was noted. There was also no significant difference between two groups postoperatively (Group 1: 1.2 ± 0.4, Group 2: 1.3 ± 0.4; P = 0.28). There were no complications in either group related to the anesthetic technique. No patient needed sedation or anesthesia supplement during the surgery or postoperative period. Conclusion. Topical anesthesia in posterior vitrectomy procedures is an effective and safe method that is alternative to retrobulbar anesthesia.

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Local versus general anaesthesia for adults undergoing pars plana vitrectomy surgery

Licina

Sidhu

Xie

et al. 2016

Cochrane Database of Systematic Reviews

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Comparison of Topical Anesthesia and Peribulbar Anesthesia for 23-Gauge Vitrectomy Without Sedation

Abstract: Topical anesthesia without any sedation is a viable option, comparable to peribulbar block, for performing vitrectomy in selected group of patients requiring vitrectomy and thus avoiding complication of injection anesthesia and quicker postoperative recovery.

Cited by 20 publications

References 40 publications

A comparison between topical and retrobulbar anesthesia in 27-gauge vitrectomy for vitreous floaters: a randomized controlled trial

A comparison between topical and retrobulbar anesthesia in 27-gauge vitrectomy for vitreous floaters: a randomized controlled trial

A Comparison of Topical or Retrobulbar Anesthesia for 23-Gauge Posterior Vitrectomy

Local versus general anaesthesia for adults undergoing pars plana vitrectomy surgery

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