The national survey of local anaesthesia for ocular surgery. II. Safety profiles of local anaesthesia techniques

Eke, Tom; Thompson, John R.

doi:10.1038/eye.1999.50

Cited by 103 publications

(62 citation statements)

References 36 publications

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“…[1][2][3][4][5][6][7] The standard LA block giving good analgesia combined with total akinesia has been superceded in many centres by topical anaesthesia, as a cooperative patient can provide acceptable surgical conditions with rapid patient recovery.…”

Section: Discussionmentioning

confidence: 99%

“…Over the last 10 years anaesthesia for cataract surgery has moved from general, to peribulbar to topical anaesthesia. [1][2][3][4][5][6][7] Vitreoretinal (VR) surgery has followed a similar pattern in many centres. Local anaesthesia has replaced general anaesthesia as it is well tolerated by patients and allows rapid postoperative recovery.…”

Section: Introductionmentioning

confidence: 99%

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Kinetic anaesthesia for laser surgery

Cuthbertson¹,

Newsom²,

Wainwright

2004

Eye

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Purpose Local anaesthetic is widely used in ophthalmic surgery and more recently in vitreoretinal surgery. Akinesia is a useful effect of local anaesthetic blocks, but there are situations where some residual globe movements are of benefit. We looked to see whether reducing the volume of anaesthetic solution used in a block could retain some kinesia while achieving good analgesia. Methods We compared two groups of patients undergoing panretinal photocoagulation (PRP) with an indirect laser. The control group received 5 ml of anaesthetic solution in a single injection by a standard intraconal technique; a second group received a lower volume of solution by the same technique. We recorded the adequacy of anaesthesia and the amount of residual kinesia for the two groups. Differences between groups were analysed using the Student's t-test and v 2 tests. Results The low-volume group received an average of 2.8 ml, compared to 5 ml in the control group. There was no significant difference in the adequacy of analgesia achieved, however 16/18 (89%: 95% confidence intervals (CI) ¼ 81.5-96.3%) of the low-volume group had good perioperative kinesia compared to just 3/21 (14%: 95% CI ¼ 6.6-21.9%) of the controls (Po0.001). Conclusions We have shown that low-volume intraconal blocks retain some perioperative kinesia without compromising their analgesic effect.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Kinetic anaesthesia for laser surgery

Cuthbertson¹,

Newsom²,

Wainwright

2004

Eye

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show abstract

“…Unfortunately, this has not proved to be the case, as the two techniques have similar incidences of globe perforation and brain-stem depression. 11,13 Sub-Tenon anaesthesia has now been associated with globe perforation, 14 and many glaucoma surgeons are concerned that the technique may jeopardise the outcome of future filtering surgery. Topical anaesthesia does avoid the risks of the needle, but some surgeons are unhappy to operate on a potentially mobile eye, and the technique does not block the oculo-cardiac and other reflexes.…”

mentioning

confidence: 99%

“…This was last done in the UK in 1996, when the Royal College of Anaesthetists and the Royal College of Ophthalmologists sponsored the National Survey of Local Anaesthesia for Ocular Surgery. 8,13 This observational study looked at safety aspects of around 65 000 LAs which were given over a 3-month period. Sight-and life-threatening complications were reported in around 0.05% of retrobulbar and peribulbar injections, 13 although the true figure is probably higher 11 due to underreporting.…”

mentioning

confidence: 99%

“…8,13 This observational study looked at safety aspects of around 65 000 LAs which were given over a 3-month period. Sight-and life-threatening complications were reported in around 0.05% of retrobulbar and peribulbar injections, 13 although the true figure is probably higher 11 due to underreporting. There were too few cases performed using sub-Tenon, subconjunctival, topical or topical-intracameral anaesthesia to assess their safety with any degree of certainty.…”

mentioning

confidence: 99%

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