Topical versus peribulbar anaesthesia for cataract surgery.
BACKGROUND
To assess and compare the efficacy and safety of topical versus peribulbar anaesthesia in patients undergoing routine cataract surgery.


METHODS
The unicentre, prospective, randomized, clinical interventional trial included 140 consecutive patients undergoing routine cataract surgery performed by one of two surgeons. The patients were randomly distributed to either peribulbar anaesthesia or topical anaesthesia. To assess intraoperative pain, each patient was asked immediately after surgery to quantitate his/her pain using a 10-point pain rating scale.


RESULTS
The study groups did not differ significantly in pain score (p=0.54), duration of surgery (p=0.52), anaesthesia-related intraoperative difficulties (p=0.17), postoperative visual acuity (p=0.94), overall intraoperative surgical complication rate, blood pressure rise (p=0.16) or blood oxygen saturation (p=0.74)


CONCLUSIONS
Patient comfort and surgery-related complications did not differ between topical anaesthesia and peribulbar anaesthesia. As there are no significant differences between the two techniques in terms of subjective pain experienced by patients, intraoperative complications and postoperative visual outcome, and in view of the minimally invasive character of topical anaesthesia compared to peribulbar anaesthesia, the present study suggests the use of topical anaesthesia for routine cataract surgery.
Sauder
Gangolf
G
Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Gangolf.Sauder@augen.ma.uni-heidelberg.de
Jonas
Jost B
JB
D000287:Administration, Topical; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019923:Capsulorhexis; D005260:Female; D006801:Humans; D007267:Injections; D019654:Lens Implantation, Intraocular; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D009915:Orbit; D010149:Postoperative Pain; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011343:Procaine / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D011446:Prospective Studies; D012449:Safety
D000779:Anesthetics, Local; D009883:Ophthalmic Solutions; D011343:Procaine; C005298:benoxinate; D008619:Mepivacaine