Anesthesia through a novel retrobulbar catheter provides perioperative pain control for 24 h after pars plana vitrectomy.
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mepivacaine 2% were injected, a 28-gauge flexible catheter was introduced into the retrobulbar space and the needle was withdrawn.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.
Jonas
J B
JB
Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Jost.Jonas@augen.ma.uni-heidelberg.de
Jäger
M
M
Hemmerling
T M
TM
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
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine