title: Comparison of analgesia and akinesia after retrobulbar injections at different speeds.
abstract: OBJECTIVE
  To assess how the speed of injection of local anesthetic solutions affected pain of injection, bulbar akinesia and analgesia with retrobulbar anesthesia (RBA).
  
  
  METHODS
  70 patients undergoing RBA for cataract surgery were enrolled in a prospective masked trial. They were allocated randomly to receive 5 ml anesthetic solution injected either within 20 seconds (group A) or within 60 seconds (group B). Additionally, akinesia of the orbicularis muscle was created according to O'Brien's technique. The pain of injection was registered on an ordinal analogue scale immediately before and after RBA. The following data were collected before and 20 minutes after retrobulbar injection: eye motility (Kestenbaum test), and corneal sensitivity (0: no sensitivity; 1: sensitivity remaining). Data were also collected on age, sex, and bulbar length, and any side effects of the intervention.
  
  
  RESULTS
  Injection pain did not differ in the two groups. After RBA horizontal and vertical eye motility was slightly lower in group A than group B. Persistent motility was found in 18 patients in group A and 16 in group B. Median horizontal and vertical motility was 0 mm in both groups. Four patients in group A and five in group B had corneal sensitivity persisting after RBA.
  
  
  CONCLUSIONS
  This comparison of different injection velocities brought to light no significant differences regarding bulbar analgesia and akinesia after RBA.
authors.affiliation: Department of Ophthalmology and Eye Hospital, University of Saarland, Homburg (Saar), Germany. krausematthias@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Krause
authors.forename: A
authors.initials: A
authors.lastname: Baldus
authors.forename: S
authors.initials: S
authors.lastname: Spang
authors.forename: J
authors.initials: J
authors.lastname: Weindler
authors.forename: K W
authors.initials: KW
authors.lastname: Ruprecht
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002387:Cataract Extraction; D003315:Cornea / Q000502:physiology; D004311:Double-Blind Method; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D009801:Oculomotor Muscles / Q000502:physiology*; D009915:Orbit; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D012677:Sensation / Q000502:physiology; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local