title: An evaluation of the administration of sub-Tenon local anaesthesia by a nurse practitioner.
abstract: OBJECTIVE
  To evaluate the administration of sub-Tenon local anaesthesia (LA) by a nurse practitioner.
  
  
  METHODS
  106 consecutive patients listed for cataract surgery were given sub-Tenon's anaesthesia by a nurse practitioner. The surgical procedure was performed within 15 minutes of the administration of the LA. Pain, state and adequacy of anaesthesia, appearance of the eye, and patient anxiety were measured. Patients' experiences of this new nursing role were gained through interview.
  
  
  RESULTS
  At the beginning of surgery, few patients showed eye movement in any of the four quadrants and the surgeons reported that akinesia was inadequate in only seven (7.1%) cases. Three patients (3.3%) gave a pain score of 3 out of 10 or above during surgery whereas the surgeons assessed the pain relief to be inadequate in eight (8.1%) cases. Five (5.3%) patients required a top up of anaesthesia and 51 (39.8%) patients developed conjunctival chemosis in two or more quadrants. Overall, patients' comments indicate that they were pleased with the new service.
  
  
  CONCLUSIONS
  The results suggest that nurse practitioner delivered sub-Tenon LA is an effective and safe method of LA administration for cataract surgery.
authors.affiliation: School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UK. heather.waterman@man.ac.uk
authors.forename: H
authors.initials: H
authors.lastname: Waterman
authors.forename: S
authors.initials: S
authors.lastname: Mayer
authors.forename: M J
authors.initials: MJ
authors.lastname: Lavin
authors.forename: A F
authors.initials: AF
authors.lastname: Spencer
authors.forename: C
authors.initials: C
authors.lastname: Waterman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000451:nursing*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001007:Anxiety / Q000209:etiology; D005133:Eye Movements / Q000187:drug effects; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D010146:Pain / Q000451:nursing / Q000517:prevention & control; D010147:Pain Measurement; D017060:Patient Satisfaction; D018918:Phacoemulsification / Q000451:nursing*
chemical_list: D000779:Anesthetics, Local