The efficacy of retrobulbar block anesthesia only in pars plana vitrectomy and transconjunctival sutureless vitrectomy.
OBJECTIVE
To evaluate the adequacy of retrobulbar block anesthesia only in vitreoretinal surgery.


METHODS
The study involved 90 patients, 25 who underwent 25-gauge transconjunctival sutureless vitrectomy and 65 who underwent 20-gauge standard pars plana vitrectomy. Twenty-five of the 90 patients also underwent combined phacoemulsification and posterior intraocular lens implantation. The efficacy of retrobulbar block anesthesia only was assessed by monitoring vital signs during surgery, reviewing patient responses to a questionnaire regarding their experience during surgery, and analyzing surgical outcomes.


RESULTS
Four patients complained of moderate pain during surgery, but no patient complained of severe pain. Infiltrative anesthesia was additionally required in 14 patients. No patient experienced intraoperative complications due to head movement. Increased systolic blood pressure greater than 15 mm Hg occurred in 11 patients and increased respiratory rate by 3 breaths per minute or greater occurred in 7 patients. Anatomical and functional success rates were 95% and 80%, respectively. Complications included manageable retrobulbar bleeding (1 patient) and postoperative neovascular glaucoma (2 patients).


CONCLUSIONS
Vitreoretinal surgery, particularly 25-gauge transconjunctival sutureless vitrectomy, can be safely and efficiently performed under retrobulbar block anesthesia only. Retrobulbar block anesthesia only could become a more acceptable anesthesia for vitreoretinal surgery for selected patients.
Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Taehyung H
TH
Lim
Mark S
MS
Humayun
Young Hee
YH
Yoon
Yong Hyuk
YH
Kwon
June-Gone
JG
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage; D003228:Conjunctiva; D003975:Diazepam / Q000008:administration & dosage; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D009915:Orbit; D010147:Pain Measurement; D010149:Postoperative Pain; D018918:Phacoemulsification; D012164:Retinal Diseases / Q000601:surgery; D013536:Suture Techniques; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000601:surgery
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D008012:Lidocaine; D003975:Diazepam; D002045:Bupivacaine