[Anesthesia for vitreoretinal surgery using a retrobulbar catheter technique].
OBJECTIVE
To evaluate peroperative pain management using a flexible spinal anesthesia catheter introduced into the retrobulbar space which allows injections of local anesthetics for vitreoretinal surgery.


METHODS
Twenty-five patients who underwent vitreoretinal surgery receiving retrobulbar anesthesia with 3.5 ml ropivacaine 0.75%. After injection, a catheter with spinal needle 22G x 1 1/2 (40 x 0.7 mm) was introduced to the retrobulbar muscle cone. The needle was withdrawn and the catheter was fixed. When the patient started to feel pain (grade 3 or higher), 2 ml ropivacaine 0.75% was administrated through the catheter during surgery or 2 ml ropivacaine 0.2% in the postoperative period. The catheter was removed 24- 48h later.


RESULTS
During surgery, 1 patient (4%) received a re-injection of 2 ml ropivacaine 0.75% because of pain. Three patients (12%) experienced pain of grade 3 or higher in the postoperative period and needed re-injection of 2 ml ropivacaine 0.2%. Re-injections were an effective method to achieve analgesia. Adverse effects were not noticed.


CONCLUSIONS
The retrobulbar catheter technique is a procedure which allows multiple re-injections of local anesthetics; it provides adequate analgesia during surgery and rapid, effective and safe postoperative pain management.
Falcó-Molmeneu
E
E
Hospital General de Castellón, España.
Sorlí-Clemente
E
E
Ramos-Martí
F
F
Cabrera-Peset
A
A
Andrés-Calvo
G
G
Peris-Molés
M
M
D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002404:Catheterization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D017060:Patient Satisfaction; D012160:Retina / Q000601:surgery*; D000077212:Ropivacaine; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014822:Vitreous Body / Q000601:surgery*
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine