Sub-tenon anesthesia for segmental scleral buckling and assessment of postoperative pain.
BACKGROUND
To evaluate the safety and efficacy of sub-Tenon anesthesia for segmental scleral buckling.


METHODS
Thirty-two patients diagnosed with rhegmatogenous retinal detachment were treated with segmental scleral buckling under sub-Tenon anesthesia. After topical anesthesia, a buttonhole was made through the conjuntiva and Tenon's capsule 4 mm posterior to the limbus. Four milliliters of anesthetic solution was then delivered into the posterior sub-Tenon space using a blunt cannula. The buckling procedure was done immediately after the completion of anesthesia. We evaluated akinesia and recorded the pain with a visual analogue scale after surgery.


RESULTS
There were no anesthesia related complications. Twenty-two patients (69%) reported no pain during surgery. Nine patients (28%) felt pain during surgery. However, the pain was tolerable and the surgeries were finished smoothly with or without a supplemental anesthetic solution. One patient (3%) experienced uncomfortable pain and needed an additional retrobulbar block. Five patients (16%) retained complete eye movement 5 min after anesthesia, and only 4 patients (13%) experienced total akinesia. At the end of the surgery, 16 patients (50%) had total akinesia and 2 patients (6%) retained complete eye movement.


CONCLUSIONS
Sub-Tenon anesthesia is efficient and safe in segmental scleral buckling. It can prevent the complications of peribulbar or retrobulbar anesthesia and is a good alternative to both methods of anesthesia, especially in highly myopic eyes.
Chuang
Lan-Hsin
LH
Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
Wu
Wei-Chi
WC
Yang
Ko-Jen
KJ
Tsao
Yeou-Ping
YP
Chen
Tun-Lu
TL
Lai
Chi-Chun
CC
D000293:Adolescent; D000328:Adult; D000772:Anesthesia, Local / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D012591:Scleral Buckling / Q000379:methods*