Comparison of subtenon anaesthesia with peribulbar anaesthesia for manual small incision cataract surgery.
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.
Parkar
Tasneem
T
HV Desai Eye Hospital, Pune, India.
Gogate
Parikshit
P
Deshpande
Madan
M
Adenwala
Arif
A
Maske
Amar
A
Verappa
K
K
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
D000779:Anesthetics, Local