Topical versus sub-Tenon's anesthesia without sedation in cataract surgery

Zafirakis, Panayotis; Voudouri, Adamantia; Rowe, Susannah; Livir-Rallatos, Gerasimos; Livir-Rallatos, Charalampos; Canakis, Christina; Kokolakis, Stefanos; Baltatzis, Stefanos; Theodossiadis, George

doi:10.1016/s0886-3350(00)00703-3

Cited by 58 publications

(38 citation statements)

References 19 publications

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“…The volume of local anaesthetic chosen may appear excessive, but most published studies advocate this volume 1,9,12,13 to achieve anaesthesia, adequate reduction of ocular movements, and to reduce the need for supplementary injections. The incidence of pain on injection, 1,12,14,15 chemosis, 1,9,12,14 and conjunctival haemorrhage 1,9,12,14 are similar to those in other published studies. Chemosis was noted with all three cannulae, suggesting that fluid often tends to spread anteriorly, irrespective of the length of the cannula.…”

Section: Discussionsupporting

confidence: 89%

Ultrasonic localization of anaesthetic fluid using sub-Tenon's cannulae of three different lengths

Kumar

McNeela

2003

Eye

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Purpose To study the distribution of anaesthetic fluid during sub-Tenon's block by B-scan ultrasonography using cannulae of three different lengths. Methods A total of 30 patients undergoing routine phacoemulsification and lens implantation were studied after informed consent had been obtained. Ages ranged from 60 to 92 years and globe axial lengths from 21.50 to 27.00 mm. All were given a subTenon's block and the patients were classified into three groups in which either a long, intermediate, or short cannula was used. Bscan ultrasonography was performed before administration of the anaesthetic agent, during injection, and 2 min after completion of the injection. Results In all patients the optic nerve was identified. During the injection, anaesthetic fluid could be seen tracking behind the globe and opening up the posterior sub-Tenon's space (the previously described 'T'-sign). After 2 min very little or no fluid was seen, suggesting that it had dispersed into the surrounding tissues. There was no discernible difference in the distribution of fluid or in the quality of the block in the three groups. Conclusions B-scan ultrasonography can reliably identify the distribution of anaesthetic fluid during sub-Tenon's block. Anaesthetic agents can be successfully delivered into the sub-Tenon's space by long, intermediate, or short cannulae.

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Section: Discussionsupporting

confidence: 89%

Ultrasonic localization of anaesthetic fluid using sub-Tenon's cannulae of three different lengths

Kumar

McNeela

2003

Eye

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“…O volume injetado varia entre 2 a 5 ml (8,20, 2 4) . A possibilidade de ocorrer perfuração ocular não foi relatada até os dias de hoje (20) , mas a presença de hematoma retrobulbar foi descrita em um caso (31) , além de hemorragia subconjuntival e quemose (32) . A anestesia tópica foi primeiramente descrita em 1884 (32) usando cocaína 5%, porém não se tornou muito aceita devido a seus efeitos tóxicos (33) .…”

Section: Introductionunclassified

“…A possibilidade de ocorrer perfuração ocular não foi relatada até os dias de hoje (20) , mas a presença de hematoma retrobulbar foi descrita em um caso (31) , além de hemorragia subconjuntival e quemose (32) . A anestesia tópica foi primeiramente descrita em 1884 (32) usando cocaína 5%, porém não se tornou muito aceita devido a seus efeitos tóxicos (33) . Somente em 1991 Fichmam (34)(35) utilizou tetracaína 0,5% em forma de colírio para realizar cirurgia de facoemulsificação sendo este utilizado até os dias de hoje para realizar cirurgias de catarata em córnea clara e túnel escleral, trabeculectomia (36) e estrabismo (37) .…”

Section: Introductionunclassified

“…Somente em 1991 Fichmam (34)(35) utilizou tetracaína 0,5% em forma de colírio para realizar cirurgia de facoemulsificação sendo este utilizado até os dias de hoje para realizar cirurgias de catarata em córnea clara e túnel escleral, trabeculectomia (36) e estrabismo (37) . Kershner em 1993 (32,35) usou no lugar da tetracaína a proparacaína 0,5% tópica para os mesmos fins. Recentemente o uso desta técnica vem aumentando como alternativa para reduzir os riscos associados com a injeção de anestésicos (38) .…”

Section: Introductionunclassified

“…Recentemente o uso desta técnica vem aumentando como alternativa para reduzir os riscos associados com a injeção de anestésicos (38) . Este procedimento não leva a acinesia completa (34,39) bem como não bloqueia a inervação do corpo ciliar, podendo o paciente queixar-se de dor em procedimentos que levem a distorção ou pressão do olho (39) , principalmente em procedimentos sem sedação (32) . Segundo Fukasaku (36) uma técnica anestésica local ideal deveria satisfazer os seguintes critérios:…”

Section: Introductionunclassified

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Análise de custo dos materiais usados para realizar as técnicas anestésicas na cirurgia programada de extração de catarata por facoemulsificação

Barreiro

Rehder

2004

Arq. Bras. Oftalmol.

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Purpose:To compare the costs of local anaesthesia (retrobulbar block, peribulbar block, sub-Tenon and topical) to perform phacoemulsification cataract extraction. Methods: We studied the costs of the materials that are necessary to perform the local anaesthesia (retrobulbar block, peribulbar block, sub-Tenon and topical). We adopted the standard technique used for the Cataract Sector of the Department of Ophthalmology, ABC University. For each technique the total price of the each item to perform the above described local anaesthesia was analyzed. Prices were obtained from three different stores which sell hospitals materials and we considered for this study the item with a lower price. Results: The costs of topical anaesthesia were 0.06 reais, for the retrobulbar it was 7.42 reais, 24.96 reais for the peribulbar was and 48.12 reais for the sub-Tenon. Conclusions: 1. Topical anaesthesia showed the lowest cost. 2. Retrobulbar anaesthesia showed low cost when compared with the peribulbar and sub-Tenon 3. Sub-Tenon's anaesthesia showed the highest cost. Ao enviar um artigo para publicação, leia ATENTAMENTE as instruções para autores, constante no final de cada fascículo. Keywords

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