Effectiveness of local anaesthesia for external dacryocystorhinostomy.
OBJECTIVE
To establish the effectiveness, complications and patient acceptance of local anaesthesia (LA) with intra-venous sedation, for external dacryocystorhinostomy (DCR).


METHODS
Data were prospectively collected over a 4-year period (1997-2000) on all patients undergoing external DCR under LA with intravenous sedation by one surgeon and one anaesthetist, using a standardized technique.


RESULTS
Of 183 DCR procedures, 145 (76.5%) were performed using LA in 123 patients aged 24-84 years (median 64 years). Eleven simultaneous bilateral DCR procedures were performed under LA. Another 11 patients had a contralateral DCR at a later date. In only three DCR (2.1%) was supplementation of LA required during the procedure because of pain. The only complication of the technique was one retrobulbar haemorrhage from the medial peribulbar injection. In this patient, the procedure was completed satisfactorily without further sequelae. All patients found the technique acceptable and all 11 patients who returned for surgery on the opposite side at a later date elected to have surgery under LA again.


CONCLUSIONS
External DCR can be satisfactorily and safely performed under LA with a high level of patient acceptance.
McNab
Alan A
AA
Orbit, Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia. amcnab@bigpond.com
Simmie
Richard J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D016292:Procedural Sedation; D003608:Dacryocystorhinostomy / Q000379:methods*; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery; D017060:Patient Satisfaction; D011446:Prospective Studies; D012449:Safety
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008874:Midazolam; D005283:Fentanyl