Single-injection percutaneous peribulbar anesthesia with a short needle versus sub-Tenon′s anesthesia for cataract extraction

Abstract

Purpose:This study compared the efficacy of single-injection percutaneous peribulbar anesthesia (PBA) with a short needle with sub-Tenon's anesthesia (STA) to produce optimal operating conditions for cataract extraction in patients with complicated cataract.Methods:Two hundred patients with complicated cataract were enrolled in this prospective, double-blinded, randomized study. Adequate akinesia was a surgical requisite for all cases included in the study because of the expected difficult surgery. The patients were divided into two equal groups to receive either peribulbar anesthesia (PBA) with a 16-mm needle or sub-Tenon's anesthesia. Surgical akinesia (as a primary end point), analgesia, incidence of complications, as well as patient and surgeon satisfaction (as secondary end points) were assessed.Results:Both techniques provided similar analgesia during the operation and similar rates of incidence of chemosis with no serious complications; while the PBA group provided higher degree of akinesia 10 minutes after injection of the local anesthetic, a lower incidence of subconjunctival hemorrhage (SCH) and higher patient and surgeon satisfaction compared to the STA group.Conclusion:We concluded that when globe akinesia is necessary during surgery, the single-injection technique for percutaneous peribulbar anesthesia with a short needle proved to be more suitable than the STA in providing akinesia for cataract surgery. Also, this PBA technique demonstrated a lower incidence of SCH and was preferred to STA by the patients and surgeon.

Efficacy and Safety of Magnesium versus Dexmedetomidine as Additives to Local Anesthetic Mixture Using Single Injection Percutaneous Peribulbar Anesthesia in Vitreoretinal Surgeries

“…In our study, we planned to compare between dexmedetomidine and Magnesium sulphate as an adjuvant to local anesthetic mixture using the single injection technique for percutaneous peribulbar anesthesia with a short needle as described by Rizzo et al [11] it has been proved to be a simple and easy-to-perform technique with less pain, using a decreased volume of local anesthetic. The hypothesis of the efficacy of this technique was revealed in previous studies [12] using B-scan ultrasonography which demonstrated that a small volume of local anesthetics diffused circumferentially from the extraconal to the intraconal space, where the sensory and motor nerves of the eye are located [13].…”

Periocular hematoma secondary to subperiosteal injury by a short needle

“…[1–3] It is considered to be a minimally invasive approach that is less likely associated with block-related complications. We report a case of subperiosteal hemorrhage that led to a subperiosteal and periocular hematoma as a complication of peribulbar block with a short needle.…”