June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
A Comparison of Retrobulbar, Sub-Tenon's Anesthesia and Canthal Anestesia for 25-Gauge Posterior Vitrectomy
Author Affiliations & Notes
  • Derri Roman Pognuz
    Department of Ophthalmology, Ca Foncello Hospital, ULSS 9 , Treviso, Italy
  • Giuseppe Scarpa
    Department of Ophthalmology, Ca Foncello Hospital, ULSS 9 , Treviso, Italy
  • Luigi Spedicato
    Department of Ophthalmology, Ca Foncello Hospital, ULSS 9 , Treviso, Italy
  • Footnotes
    Commercial Relationships   Derri Roman Pognuz, None; Giuseppe Scarpa, None; Luigi Spedicato, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2799. doi:
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      Derri Roman Pognuz, Giuseppe Scarpa, Luigi Spedicato; A Comparison of Retrobulbar, Sub-Tenon's Anesthesia and Canthal Anestesia for 25-Gauge Posterior Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2799.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Retrobulbar is commonly used for ocular posterior segment surgery. As is known, many complications have been reported with injection anesthesia, including globe perforation, injury to optic nerve, cranial nerve palsies, restrictive strabismus, diplopia, ptosis, retinal vein and artery occlusion, seizures and cardiorespiratory arrest. Previous studies have demonstrated that Sub-Tenon and canthal anestesia can be safe.
The aim of the study is to compare the efficacy, safety and globe akinesia between retrobulbar, Sub-Tenon's anesthesia and canthal anestesia for 25-Gauge posterior vitrectomy.

Methods : A total of 90 patients scheduled for 25 G posterior vitrectomy were included in the study.
The patients were randomly assigned to receive retrobulbar (Group 1, n=30), Sub-Tenon's anesthesia (Group 2, n=30) and canthal anestesia (Group 3, n=30).
Globe akinesia was recorded on the side injected at 2,5 and 10 min time intervals. A scoring system was used to evaluate the akinesia. Eye movement in four directions is elicited superiorly, inferiorly, nasally and temporally. A normal movement scored two, partial movement scored one and no movement scored zero.
One hour after surgery each patient was shown a visual analogue pain scale (VAPS) with numeric and descriptive ratings from 1 (no pain and discomfort) to 4 (severe pain and discomfort). Patients were asked to rate the VAPS for surgical conditions, pain during administration of anesthesia, pain during surgery, and postoperative pain.

Results : There was an incomplete akinesia in Group 3. There was no difference in the akinesia score in Groups 1 and 2. There was more discomfort in patients in Group 1 while anesthetic was administered. Between the three groups, the level of pain during surgery was not noted. There was also no significant difference between the three groups postoperatively. There were no complications in either group related to the anesthetic technique. No patient needed sedation or anesthesia supplement during the surgery or postoperative period.

Conclusions : Sub-Tenon and canthal anesthesia are effective and safe methods that are alternatives to retrobulbar anesthesia in posterior vitrectomy

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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