Parabulbar anesthesia for primary vitreoretinal surgery.
OBJECTIVE
The efficacy and safety of parabulbar anesthesia was investigated prospectively in 100 patients undergoing primary vitreoretinal surgery.


METHODS
The technique involved three steps: (1) orbicularis oculi injection, (2) subconjunctival injection, and (3) sub-Tenon irrigation. The effect of anesthesia was graded 0 to 5 depending on inadequate anesthesia-akinesia with or without local supplementation. Ninety-three patients underwent vitrectomy without buckling and 4 with an encircling band; 3 had scleral buckling. Mean duration of surgery was 89.38 minutes.


RESULTS
In 69% of patients (grades 4 and 5), no supplementation was required and in 31% (grades 1-3), local supplementation was needed for inadequate anesthesia or akinesia or both. No ocular or systemic complication occurred. Early onset of anesthesia correlated with adequate anesthesia throughout the procedure (P < 0.04).


CONCLUSIONS
Parabulbar anesthesia is a safe and effective technique of local anesthesia in patients undergoing primary vitreoretinal surgery.
Sharma
T
T
Vitreoretinal Service, Madras, India.
Gopal
L
L
Parikh
S
S
Shanmugam
M P
MP
Badrinath
S S
SS
Mukesh
B N
BN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009915:Orbit; D011446:Prospective Studies; D012163:Retinal Detachment / Q000601:surgery*; D012449:Safety; D012591:Scleral Buckling; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000601:surgery*
D000779:Anesthetics, Local; D004338:Drug Combinations; D008012:Lidocaine; D002045:Bupivacaine