title: Comparison of subtenon anaesthesia with peribulbar anaesthesia for manual small incision cataract surgery.
abstract: OBJECTIVE
  To compare the safety and efficacy of subtenon anaesthesia with peribulbar anaesthesia in manual small incision cataract surgery using a randomised control clinical trial.
  
  
  METHODS
  One hundred and sixty-eight patients were randomised to subtenon and peribulbar groups with preset criteria after informed consent. All surgeries were performed by four surgeons. Pain during administration of anaesthesia, during surgery and 4 h after surgery was graded on a visual analogue pain scale and compared for both the techniques. Sub-conjuntival haemorrhage, chemosis, akinesia after administration of anaesthesia and positive pressure during surgery were also compared. Patients were followed up for 6 weeks postoperatively.
  
  
  RESULTS
  About 146/168 (86.9%) patients completed the six-week follow-up. Thirty-one out of 88 (35.2%) patients of peribulbar group and 62/80(77.5%) of subtenon group experienced no pain during administration of anaesthesia. There was no significant difference in pain during and 4 h after surgery. Subtenon group had slightly more sub-conjunctival haemorrhage. About 57 (64.8%) patients of the peribulbar group had absolute akinesia during surgery as compared to none (0%) in sub-tenon group. There was no difference in intraoperative and postoperative complications and final visual acuity.
  
  
  CONCLUSIONS
  Sub-tenon anaesthesia is safe and as effective as peribulbar anaesthesia and is more comfortable to the patient at the time of administration.
authors.affiliation: HV Desai Eye Hospital, Pune, India.
authors.forename: Tasneem
authors.initials: T
authors.lastname: Parkar
authors.forename: Parikshit
authors.initials: P
authors.lastname: Gogate
authors.forename: Madan
authors.initials: M
authors.lastname: Deshpande
authors.forename: Arif
authors.initials: A
authors.lastname: Adenwala
authors.forename: Amar
authors.initials: A
authors.lastname: Maske
authors.forename: K
authors.initials: K
authors.lastname: Verappa
mesh_terms: D000772:Anesthesia, Local / Q000009:adverse effects / Q000379:methods* / Q000592:standards*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002387:Cataract Extraction / Q000379:methods*; D003229:Conjunctival Diseases / Q000209:etiology; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local