Preemptive analgesia in rhegmatogenous retinal detachment surgery: is it effective?
OBJECTIVE
To evaluate the efficacy of preemptive analgesia in surgical repair of retinal detachment (RD) using scleral buckle and cryopexy under general anesthesia.


METHODS
Thirty patients who were scheduled for rhegmatogenous RD surgical repair using scleral buckle and cryopexy and who were American Society of Anesthesiologists physical status I, II, or III were included in this study. The patients were randomly divided into two equal groups. The surgery was done under general anesthesia in both groups, but in Group 2, sub-Tenon anesthesia was given as preemptive analgesia after induction anesthesia and before start of surgery. Both groups were statistically comparable as regards patient age and weight and duration of anesthesia and surgery.


RESULTS
The incidences of intraoperative oculocardiac reflex and postoperative vomiting were significantly lower in Group 2 compared with Group 1 (P < 0.001 and 0.0113, respectively). The time of first postoperative analgesic dose was significantly shorter in Group 1 (46.67 +/- 18.84 minutes) compared with Group 2 (162.67 +/- 29.391 minutes) (P < 0.001). The total analgesic consumption per 24 hours was significantly higher in Group 1 compared with Group 2 (P < 0.001). The time of discharge from the hospital was significantly shorter in Group 2 (8.8 +/- 2.704 hours) compared with Group 1 (12.4 +/- 3.481 hours) (P = 0.0018).


CONCLUSIONS
The use of sub-Tenon block as preemptive analgesia after induction of general anesthesia and before the start of rhegmatogenous RD surgical repair was effective in reducing postoperative pain and analgesic requirements compared with an unblocked group. The use of sub-Tenon block was also effective in reducing intraoperative incidence of oculocardiac reflex and postoperative incidence of vomiting.
Mahfouz
Abdul Kader M
AK
Anesthesia Department, Faculty of Medicine, Alexandria University, Egypt.
Nabawi
Khaled S
KS
D000293:Adolescent; D000328:Adult; D000698:Analgesia / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods; D000772:Anesthesia, Local / Q000379:methods; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D003452:Cryosurgery; D006221:Halothane / Q000008:administration & dosage; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008012:Lidocaine / Q000008:administration & dosage; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D010197:Pancuronium / Q000008:administration & dosage; D011343:Procaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D015742:Propofol / Q000008:administration & dosage; D012163:Retinal Detachment / Q000601:surgery*; D012591:Scleral Buckling
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D011343:Procaine; D008012:Lidocaine; C005298:benoxinate; D010197:Pancuronium; D006221:Halothane; D002045:Bupivacaine; D015742:Propofol