Extracapsular cataract extraction under local anaesthesia without retrobulbar injection.

Redmond, R M; Dallas, N L

doi:10.1136/bjo.74.4.203

Cited by 59 publications

(13 citation statements)

References 8 publications

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“…[18][19][20][21] This technique, however, involves injection of anaesthetic with a sharp needle or blunt cannula which may result in complications such as subconjunctival haemorrhage, chemosis, conjunctival injection holes, and even globe perforation. A potential advantage of sub-Tenon's anaesthesia is in cases of re-operation where the infiltration of anaesthetic fluid separates Tenon's capsule and conjunctiva from episclera, thus allowing the surgeon to check for conjunctival mobility when choosing a site for surgery.…”

Section: Discussionmentioning

confidence: 99%

Prospective study comparing lidocaine 2% jelly versus sub-Tenon's anaesthesia for trabeculectomy surgery

Carrillo

Buys²,

Faingold³

et al. 2004

British Journal of Ophthalmology

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Aims: To compare the analgesic properties of lidocaine 2% jelly versus sub-Tenon's anaesthesia with lidocaine 2% without adrenaline (epinephrine) for trabeculectomy surgery. Methods: A prospective randomised clinical trial. 59 consecutive patients scheduled for trabeculectomy at the Toronto Western Hospital were randomly assigned to topical unpreserved lidocaine 2% jelly or sub-Tenon's anaesthesia with 2% lidocaine. Both groups received a standardised sedative consisting of midazolam, fentanyl. and/or propofol. The visual analogue scale was utilised to measure intraoperative pain. Patient comfort, physician assessment of intraoperative patient compliance, volume of local anaesthetic used, need for supplemental anaesthesia, and any complications were recorded. The two groups were compared using the Student's t test. Results: The sub-Tenon's anaesthesia group and the lidocaine 2% jelly group did not vary significantly in subjective pain score (18.3 (SD 16.2) v 19.8 (12.4) respectively, p = 0.739) and surgeons' satisfaction scale (3.6 (0.7) and 3.8 (0.6) respectively, p = 0.328). Four patients required additional anaesthesia, all of them in the sub-Tenon's group. Conclusion: Topical lidocaine 2% jelly is as effective as subTenon's anaesthesia for pain control in patients undergoing trabeculectomy. Lidocaine 2% jelly is similar to sub-Tenon's anaesthesia in patient comfort and surgeon satisfaction.

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Section: Discussionmentioning

confidence: 99%

Prospective study comparing lidocaine 2% jelly versus sub-Tenon's anaesthesia for trabeculectomy surgery

Carrillo

Buys²,

Faingold³

et al. 2004

British Journal of Ophthalmology

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show abstract

“…The search for such a local anaesthetic technique started even before the introduction of retrobulbar block by Herman Knapp in 1884 and is yet to be finished. The recommendation of subconjunctival anaesthesia for cataract surgery by Redmond & Dallas (1990) and Smith (1990), prompted us to compare this technique with the posterior peribulbar technique being used routinely by us. Khurana's block evaluation scoring system (Table 1) adopted in the present study, which is based on the levels of orbicularis akinesia, ocular akinesia, sensory anaesthesia and analgesia and intraocular pressure, seems more reliable and easy to interpret than the Redmond & Dallas' (1990), Smith's (1990) and Hamilton's (1988) systems.…”

Section: Discussionmentioning

confidence: 99%

“…During the last decade, however, peribulbar anaesthesia technique popularised by Davis (1986) has almost replaced the time-tested combination of retrobulbar and facial block. Recently, a few reliable reports (Redmond & Dallas 1990;Smith 1990) have recommended subconjunctival anaesthesia for routine cataract surgery, however, not many studies are available in the literature recommending this technique as the local anaesthesia of choice. The present study was therefore carried our to comment on the comparative status of these two techniques.…”

mentioning

confidence: 99%

Evaluation of subconjunctival anaesthesia vs peribulbar anaesthesia in cataract surgery

Khurana¹,

Sachdeva²,

Gombar³

et al. 1994

Acta Ophthalmologica

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A comparative study was carried out to evaluate peribulbar anaesthesia (group A) vs subconjunctival anaesthesia (group B). The results proved peribulbar anaesthesia to be more effective than subconjunctival anaesthesia as regards orbicularis akinesia (p < 0.05) and ocular akinesia (p < 0.05). There was no significant difference in the sensory anaesthesia, analgesia and intraocular pressure changes in the two groups (p > 0.05). Block assessment was ideal in 80% of patients in group A in comparison to 51% in group B (p < 0.05), and unsatisfactory in 14% in group A and 30% in group B (p < 0.05). Further, no significant complications were observed with peribulbar anaesthesia. Therefore, we conclude that peribulbar anaesthesia should be preferred over subconjunctival anaesthesia for conventional extracapsular cataract extraction with or without intraocular lens implantation.

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“…Neither the actual effectiveness of each anaesthetic, nor the outcome of surgery were assessed as these have been documented elsewhere (Redmond & Dallas 1990;Smith 1990;Weiss & Deichman 1989). This study only intended to look at the complication rate of retrobulbar injections.…”

Section: Methodsmentioning

confidence: 99%

The incidence of complications associated with retrobulbar injection of anaesthetic for ophthalmic surgery

Ruben

1992

Acta Ophthalmologica

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A retrospective study of the incidence of complications associated with the use of retrobulbar injections was carried out on a sample of 1083 consecutive patients. The overall incidence of retrobulbar haemorrhage (1.3%) compared favourably with previous reports, but was found to be related to the experience of the surgeon. None of the more serious ocular complications of retrobulbar injection occurred in this sample. The relative safety of this technique is discussed.

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Extracapsular cataract extraction under local anaesthesia without retrobulbar injection.

Abstract: (RMR), and the distribution of types of anaesthesia used by the surgeon over the two-year period of the study is shown in Figure 1.

Cited by 59 publications

References 8 publications

Prospective study comparing lidocaine 2% jelly versus sub-Tenon's anaesthesia for trabeculectomy surgery

Prospective study comparing lidocaine 2% jelly versus sub-Tenon's anaesthesia for trabeculectomy surgery

Evaluation of subconjunctival anaesthesia vs peribulbar anaesthesia in cataract surgery

The incidence of complications associated with retrobulbar injection of anaesthetic for ophthalmic surgery

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