Current practice of ophthalmic anesthesia in Nigeria

Abstract

Purpose:To assess the current techniques of ophthalmic anesthesia in Nigeria.Materials and Methods:A cross sectional survey among Nigerian ophthalmology delegates attending the 36th Annual Scientific Congress of the Ophthalmology Society of Nigeria. Self administered and anonymous questionnaires were used and data were collected to include details of the institution, preferred local anesthesia techniques, the grade of doctor who administers the local anesthesia, complications, preferred facial block techniques (if given separately), and type of premedication (if used).Results:Out of the 120 questionnaires distributed, 81 forms were completed (response rate 67.5%). Out of the 74 who indicated their grade, 49 (66.2%) were consultants, 22 (29.7%) were trainees, and 3 (7.1%) were ophthalmic medical officers. For cataract surgery, peribulbar anesthesia was performed by 49.1% of the respondents, followed by retrobulbar anesthesia (39.7%). Others techniques used were topical anesthesia (5.2%), subtenon anesthesia (4.3%), subconjunctival anesthesia (2.6%), and intracameral anesthesia (0.9%). For glaucoma surgery, 47.2% of the respondents use peribulbar anesthesia, 32.1% use retrobulbar anesthesia, 9.4% used general anesthesia, and 6.6% used subconjunctival anesthesia. Among the trainees, 57.8% routinely perform retrobulbar anesthesia while 55.6% routinely perform peribulbar anesthesia. At least one complication from retrobulbar anesthesia within 12 months prior to the audit was reported by 25.9% of the respondents. Similarly, 16.1% of the respondents had experienced complications from peribulbar anesthesia within the same time period. Retrobulbar hemorrhage is the most common complication experienced with both peribulbar and retrobulbar anesthesia.Conclusion:Presently, the most common technique of local anesthesia for an ophthalmic procedure in Nigeria is peribulbar anesthesia, followed by retrobulbar anesthesia. Twelve months prior to the study, 25.9% of the respondents had experienced at least one complication from retrobulbar anesthesia and 16.1% from peribulbar anesthesia. Retrobulbar hemorrhage was the most common complication reported.

Preferred Surgical and Anesthesia Techniques for Cataract Surgery in Jordan

“…12 , 13 , 17–19 In Nigeria, peribulbar is the most common anesthesia technique for cataract surgery (49.1%) and retrobulbar is the second most common (37.9%). 20 In our results, retrobulbar anesthesia was the second most common technique used for phacoemulsification (28.3%). In a global survey of cataract practices it was found that topical anesthesia is the preferred technique among participants in more than 90% of routine cases.…”

The Development of a Virtual Simulator for a Novel Design Non-Permanent Magnetic Needle Based Eye Anesthesia Training System

“…The needle tip state was estimated in a term of Bayesian learning techniques. The distances and angle between the needle tip and sensor are modeled as (14). Thus, the needle tip position and orientation directly affect the state of the sensor array.…”

“…As a result, the trainees will not receive feedback if they enter the wrong target area, or damage crucial eye anatomies [11], [12]. Although the complication rate of expert physicians for eye anesthesia is rare (0.1%), the rate of injuries from non-experienced doctors tends to have a significant number around 4% [13], [14]. This issue elucidates the non-effective system for eye anesthesia training.…”

Local Anaesthesia in Cataract Surgery

“…In addition to this, it also decreases the intraocular pressure significantly [10] . Adekoya et al [11] reported that currently the most common technique of local anesthesia for an ophthalmic procedure in Nigeria was peribulbar anesthesia, followed by retrobulbar anesthesia. Twelve months prior to the study, 25.9% of the respondents (ophthalmologists) had experienced at least one complication from retrobulbar anesthesia and 16.1% from peribulbar anesthesia.…”