title: A comparison of retrobulbar block, sub-Tenon block, and topical anesthesia during cataract surgery.
abstract: OBJECTIVE
  This randomized, double-blinded, prospective study was performed to compare the intraoperative hemodynamic variables and the patient-reported outcomes, such as intra- and postoperative analgesia and patient satisfaction, of retrobulbar block, sub-Tenon block, and topical anesthesia during cataract surgery under monitored anesthesia care.
  
  
  METHODS
  Eighty-one patients, ASA physical status I-III, undergoing elective cataract surgery under monitored anesthesia care, aged between 43 and 78 years, were randomly assigned to three groups: retrobulbar block (group R), sub-Tenon block (group S), or topical anesthesia (group T). Three minutes after the start of monitored anesthesia care with lidocaine-propofol-remifentanil mixture, an ophthalmologist performed regional anesthesia. Intraoperative hemodynamics, pain score, and patients' satisfaction with the anesthetic experiences were recorded by a study-blinded anesthesiologist.
  
  
  RESULTS
  Mean arterial pressure and heart rate in group R were significantly higher than those in groups S and T during and just after the regional block (p<0.05). Group R required smaller dosage of patient controlled sedation and fewer supplemental bolus doses than groups S and T (p<0.05). On the other hand, group S showed the highest satisfaction scores among the three groups (p<0.05).
  
  
  CONCLUSIONS
  Sub-Tenon block seems to be better than retrobulbar block and topical anesthesia in patient satisfaction though adequate analgesia was achieved after retrobulbar block during cataract surgery under monitored anesthesia care.
authors.affiliation: Department of Anaesthesiology & Pain Medicine, Seoul National University, Bundang Hospital, Seongnam - Korea.
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Ryu
authors.forename: Minsuk
authors.initials: M
authors.lastname: Kim
authors.forename: Jae-Hyon
authors.initials: JH
authors.lastname: Bahk
authors.forename: Sang-Hwan
authors.initials: SH
authors.lastname: Do
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Cheong
authors.forename: Yong-Chul
authors.initials: YC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001794:Blood Pressure / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011446:Prospective Studies; D012119:Respiration
chemical_list: D000779:Anesthetics, Local