title: Comparison of topical anesthesia and peribulbar anesthesia for 23-gauge vitrectomy without sedation.
abstract: OBJECTIVE
  To compare the safety and efficacy of topical anesthesia versus peribulbar anesthesia for 23-gauge vitrectomy without sedation.
  
  
  METHODS
  Selected group of 60 patients with vitreous hemorrhage were divided into 2 groups and underwent 23-gauge vitrectomy. Group 1 used topical anesthesia, whereas Group 2 used peribulbar anesthesia. A 5-point Visual Analogue Scale was used to assess patients' pain score and surgeon's ease while operating. Any complications thereof were made note of.
  
  
  RESULTS
  Mean overall patients' pain scores were 1.77 ± 0.50 in Group 1 and 1.77 ± 0.43 in Group 2. Surgeon's comfort score was recorded as 0.3 ± 0.53 and 0.17 ± 0.38 in Groups 1 and 2, respectively. Mean surgical time was 33.7 ± 7.1 minutes and 30.1 ± 6.2 minutes in Groups 1 and 2, respectively. These means were not statistically significant (P > 0.05). No patient required sedation or anesthesia supplementation. Group 1 patients reported maximum pain during trocar entry, whereas Group 2 reported maximum pain during block. Group 2 patients also reported significant conjunctival chemosis and lid edema postblock.
  
  
  CONCLUSIONS
  Topical anesthesia without any sedation is a viable option, comparable to peribulbar block, for performing vitrectomy in selected group of patients requiring vitrectomy and thus avoiding complication of injection anesthesia and quicker postoperative recovery.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. deepankurmahajan@gmail.com
authors.forename: Deepankur
authors.initials: D
authors.lastname: Mahajan
authors.forename: Siddarth
authors.initials: S
authors.lastname: Sain
authors.forename: Shoryavardhan
authors.initials: S
authors.lastname: Azad
authors.forename: Tarun
authors.initials: T
authors.lastname: Arora
authors.forename: Rajvardhan
authors.initials: R
authors.lastname: Azad
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data; D011183:Postoperative Complications; D013536:Suture Techniques; D014821:Vitrectomy / Q000379:methods; D014823:Vitreous Hemorrhage / Q000601:surgery*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local