Analgesic effects of sub-Tenon's versus retrobulbar anesthesia in planned extracapsular cataract extraction.
BACKGROUND
A prospective study was conducted to compare the analgesic effects of sub-Tenon's and retrobulbar anesthesia by assessing patients' response to the visceral stimulus.


METHODS
Seven hundred and twenty eyes of 720 patients underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation. They received retrobulbar anesthesia with 3 ml lidocaine (225 eyes), retrobulbar anesthesia with 5 ml lidocaine (216 eyes), or sub-Tenon's anesthesia with 3 ml lidocaine (279 eyes). Pain scores were recorded when an acetylcholine chloride solution was injected into the anterior chamber to attain miosis after lens implantation.


RESULTS
Pain scores were significantly different among the three anesthesia groups (P<0.0001, Kruskal-Wallis test). The multiple comparison revealed that analgesic effects were highest with sub-Tenon's anesthesia, followed by 5-ml retrobulbar and 3-ml retrobulbar anesthesia.


CONCLUSIONS
Sub-Tenon's anesthesia is an effective and reliable anesthetic method in cataract surgery.
Tokuda
Y
Y
Inouye Eye Hospital, Tokyo, Japan.
Oshika
T
T
Amano
S
S
Inouye
J
J
Yoshitomi
F
F
D000109:Acetylcholine; D000368:Aged; D000698:Analgesia / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002387:Cataract Extraction; D018678:Cholinergic Agents; D003238:Connective Tissue; D005260:Female; D006801:Humans; D007267:Injections; D019654:Lens Implantation, Intraocular; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009915:Orbit; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011446:Prospective Studies
D000779:Anesthetics, Local; D018678:Cholinergic Agents; D008012:Lidocaine; D000109:Acetylcholine