Safety of local anaesthesia for cataract surgery: why we should look again

Eke, Tom; Thompson, John R.

doi:10.1038/sj.eye.6700393

Cited by 12 publications

(7 citation statements)

References 12 publications

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“…Akinetic methods such as intraconal block without facial nerve block (9%), with facial nerve block (11%), and extraconal block (17%) were used by respondents. The sub-Tenon’s block did not feature in this survey but it is used in other parts of the world [4, 5]. This review deals with the complications of commonly used akinetic blocks.…”

Section: Introductionmentioning

confidence: 99%

Complications of Ophthalmic Regional Blocks: Their Treatment and Prevention

Kumar

Dowd²

2006

Ophthalmologica

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Complications following ophthalmic regional anaesthesia are rare but are reported during both needle (intraconal and extraconal blocks) and blunt cannula (sub-Tenon’s block) techniques. At present there is no perfect technique of ophthalmic regional anaesthesia. This article reports on the complications, treatment and prevention of commonly used ophthalmic regional blocks. Thorough knowledge of the measures required to deal with complications when they occur are of paramount importance for safe clinical practice.

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Section: Introductionmentioning

confidence: 99%

Complications of Ophthalmic Regional Blocks: Their Treatment and Prevention

Kumar

Dowd²

2006

Ophthalmologica

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“…Consensus does not yet exist on whether regional or topical anesthesia is the superior option, although topical anesthesia is becoming more commonly used. [2][3][4] Relevant considerations include surgical outcomes, anesthetic complications and the need for anesthetic monitoring, patient comfort, and cost. Regional blocks have been associated with both local complications, such as retrobulbar hemorrhage, extraocular muscle damage with subsequent diplopia, blindness and increased intraoperative posterior vitreous pressure, and systemic complications, including the risk of brainstem anesthesia, a lifethreatening condition.…”

mentioning

confidence: 99%

“…Regional blocks have been associated with both local complications, such as retrobulbar hemorrhage, extraocular muscle damage with subsequent diplopia, blindness and increased intraoperative posterior vitreous pressure, and systemic complications, including the risk of brainstem anesthesia, a lifethreatening condition. 2,5 Regional blocks also require increased intravenous sedation and the presence of an anesthetist, factors tending to increase the cost of surgery. 1 Furthermore, an analysis of patient report data on 19 250 surgeries determined that intravenous sedation was associated with increased postoperative drowsiness and nausea.…”

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confidence: 99%

Safety of cataract surgery under topical anesthesia with oral sedation without anesthetic monitoring

Rocha

Turner

2007

Canadian Journal of Ophthalmology

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“…In our study, a fair proportion of respondents experienced complications from retrobulbar (25.9%) and peribulbar (16.1%) anesthesia. Retrobulbar and peribulbar injections have been associated with a greater occurrence of sight threatening complications,[9161718] compared with subtenon or topical routes. The most common serious complication reported in this study was retrobulbar hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Current practice of ophthalmic anesthesia in Nigeria

Adekoya

Onakoya

Balogun

et al. 2013

Middle East Afr J Ophthalmol

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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.

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Safety of local anaesthesia for cataract surgery: why we should look again

Cited by 12 publications

References 12 publications

Complications of Ophthalmic Regional Blocks: Their Treatment and Prevention

Complications of Ophthalmic Regional Blocks: Their Treatment and Prevention

Safety of cataract surgery under topical anesthesia with oral sedation without anesthetic monitoring

Current practice of ophthalmic anesthesia in Nigeria

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