title: The Royal College of Ophthalmologists' National Ophthalmology Database Study of vitreoretinal surgery: report 5, anaesthetic techniques.
abstract: OBJECTIVE
  To explore trends over time and variation in the use of anaesthetic techniques for vitreoretinal (VR) surgery in the UK.
  
  
  METHODS
  Prospectively collected data from 13 centres contributing >50 VR operations, including either pars plana vitrectomy (PPV) or scleral buckle (SB), between May 2000 and November 2010 were retrospectively analysed. Anaesthesia was categorised as general anaesthesia (GA) or local anaesthesia (LA) and results were reported by year, centre, grade of surgeon and type of operation.
  
  
  RESULTS
  160 surgeons performed 12 124 operations on 10 405 eyes (9935 patients); 6054 (49.9%) under GA and 6070 (50.1%) under LA. The percentage performed under GA decreased from 95.3% in 2001 to 40.9% in 2010. Within LA techniques, peribulbar or retrobulbar injection was used in 2783 (45.8%) operations and sub-Tenon's cannula in 3287 (54.2%). The proportions of operations performed under GA or LA were similar for consultants and trainees. Primary SB, primary combined PPV and SB for retinal detachment (RD), repeat RD surgery and complex vitrectomy surgery were more commonly performed under GA (85.8%, 67.0%, 63.5% and 69.4%, respectively), while primary PPV for RD, simple vitrectomy surgery and macular surgery were more commonly performed under LA (58.1%, 53.7% and 58.2%, respectively). Marked intercentre variation existed with the extremes being one centre with 100% of operations performed under GA and one centre with 98.3% under LA.
  
  
  CONCLUSIONS
  LA for VR surgery has steadily increased over the last decade in the UK but marked intercentre variation exists.
authors.affiliation: Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire, UK Ain Shams University, Cairo, Egypt.
authors.forename: Ahmed A B
authors.initials: AA
authors.lastname: Sallam
authors.affiliation: Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire, UK The Royal College of Ophthalmologists' National Ophthalmology Database, London, UK.
authors.forename: Paul H J
authors.initials: PH
authors.lastname: Donachie
authors.affiliation: Guy's and St. Thomas' NHS Foundation Trust, London, UK.
authors.forename: Tom H
authors.initials: TH
authors.lastname: Williamson
authors.affiliation: Bristol Eye Hospital, University of Bristol, Bristol, UK.
authors.forename: John M
authors.initials: JM
authors.lastname: Sparrow
authors.affiliation: Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire, UK The Royal College of Ophthalmologists' National Ophthalmology Database, London, UK.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Johnston
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods / Q000639:trends*; D000772:Anesthesia, Local / Q000379:methods / Q000639:trends*; D018681:Anesthetics, General / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D009885:Ophthalmology / Q000458:organization & administration*; D011446:Prospective Studies; D012591:Scleral Buckling; D012955:Societies, Medical / Q000706:statistics & numerical data*; D006113:United Kingdom; D014821:Vitrectomy; D057586:Vitreoretinal Surgery
chemical_list: D018681:Anesthetics, General; D000779:Anesthetics, Local
keywords: Retina; Treatment Surgery