title: Anesthesia through a novel retrobulbar catheter provides perioperative pain control for 24 h after pars plana vitrectomy.
abstract: OBJECTIVE
  The purpose of this study was to assess the retrobulbar catheter technique for perioperative pain control in pars plana vitrectomy.
  
  
  METHODS
  One hundred consecutive pars plana vitrectomies (duration 20-220 minutes) in 88 patients (age range 37-88 years) were performed by the same surgeon under retrobulbar anesthesia using a commercially available retrobulbar needle. Initially, 7 ml of mepivacaine 2% were injected, a 28-gauge flexible catheter was introduced into the retrobulbar space and the needle was withdrawn. The catheter was removed 24 h after surgery. Intraoperatively and postoperatively, the patients were asked to rate pain using a numerical scale from 0 to 10. When pain was more than grade 3, 2 ml of a local anesthetic were re-injected through the catheter.
  
  
  RESULTS
  A first re-injection was given intraoperative/y 53.0 +/- 34.6 minutes after the start of surgery during 35/100 procedures, and second and third injections were needed during 12 /100 and 4/100 procedures, respectively. The first postoperative re-injection was given 3.9 +/- 1.5 hours after the start of surgery in 54 procedures, and second and third injections were carried out in 35/100 and 10/100 procedures respectively.
  
  
  CONCLUSIONS
  The results suggest that a temporary indwelling retrobulbar catheter allows long-lasting titratable local anesthesia during pars plana vitrectomy and titratable postoperative analgesia.
authors.affiliation: Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Jost.Jonas@augen.ma.uni-heidelberg.de
authors.forename: J B
authors.initials: JB
authors.lastname: Jonas
authors.forename: M
authors.initials: M
authors.lastname: Jäger
authors.forename: T M
authors.initials: TM
authors.lastname: Hemmerling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012164:Retinal Diseases / Q000601:surgery*; D000077212:Ropivacaine; D014821:Vitrectomy
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine