Synthesis of the literature on the effectiveness of regional anesthesia for cataract surgery.
OBJECTIVE
To synthesize the findings of the randomized trials of regional anesthesia management strategies for cataract surgery.


METHODS
Literature review and analysis.


METHODS
The authors performed a systematic search of the literature to identify all articles pertaining to regional anesthesia during cataract surgery on adults. One investigator abstracted the content of each article onto a custom-designed form. A second investigator corroborated the findings. The evidence supporting the anesthesia approaches was graded by consensus as good, fair, poor, or insufficient.


METHODS
Evidence supporting the effectiveness of different forms of regional anesthesia.


RESULTS
There was good evidence that retrobulbar and peribulbar blocks provide equivalent akinesia and pain control during cataract surgery. Additionally, sub-Tenon's blocks were at least as effective as retrobulbar and peribulbar blocks. There was good evidence that retrobulbar block provides better pain control during surgery than topical anesthesia, and there was fair evidence that peribulbar block provides better pain control than topical anesthesia.


CONCLUSIONS
This synthesis of the literature demonstrates that currently used approaches to anesthesia management provide adequate pain control for successful cataract surgery, but there is some variation in the effectiveness of the most commonly used techniques. Data are needed on patient preferences to determine the optimal strategies for anesthesia management during cataract surgery.
Department of Ophthalmology, Johns Hopkins University, Baltimore, Maryland, USA.
D S
DS
Friedman
E B
EB
Bass
L H
LH
Lubomski
L A
LA
Fleisher
J H
JH
Kempen
J
J
Magaziner
M
M
Sprintz
K
K
Robinson
O D
OD
Schein
D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001340:Autonomic Nerve Block / Q000379:methods; D002387:Cataract Extraction; D006801:Humans; D009915:Orbit; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control
D000779:Anesthetics, Local