title: Comparison of Peribulbar with Posterior Sub-Tenon's Anesthesia in Cataract Surgery Among Nigerians.
abstract: OBJECTIVE
  To compare the akinetic and the analgesic effects of peribulbar and posterior sub-Tenon's anesthesia in patients undergoing cataract surgery.
  
  
  METHODS
  In a hospital-based randomized comparative interventional study, patients aged 50 years and above who underwent elective surgery for uncomplicated cataract were randomized to receive either peribulbar block or posterior sub-Tenon block. Pain during injection, surgery, and after surgery was assessed using numerical reporting scale (NRS). Limbal excursion was measured with a transparent meter rule.
  
  
  RESULTS
  A total of 152 eyes of 152 patients were studied. Peribulbar and sub-Tenon regional blocks provided comparable adequate akinesia (P = 0.06) and similar levels of analgesia (P = 0.10) during cataract surgery. Both techniques also provided similar levels of analgesia to the patient during injection and in the immediate postoperative period. Ninety-two percent of patients who had peribulbar and 97% of those who had sub-Tenon blocks reported either mild pain or no pain at all during surgery (P = 0.49). There was no report of severe pain in all patients during the stages of the surgery. Occurrence of chemosis and subconjunctival hemorrhage was more common in sub-Tenon than peribulbar anesthesia.
  
  
  CONCLUSIONS
  This study shows that peribulbar and posterior sub-Tenon routes of administering anesthetic substances is comparable in providing adequate akinesia and analgesia for cataract surgery with minimal complications. Therefore, both techniques are effective and safe for cataract surgery among Nigerians.
authors.affiliation: Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
authors.forename: Ogbonnaya N
authors.initials: ON
authors.lastname: Iganga
authors.affiliation: Department of Ophthalmology, University of Ibadan/University College Hospital, Ibadan, Nigeria.
authors.forename: Oluyemi
authors.initials: O
authors.lastname: Fasina
authors.affiliation: Department of Ophthalmology, University of Ibadan/University College Hospital, Ibadan, Nigeria.
authors.forename: Charles O
authors.initials: CO
authors.lastname: Bekibele
authors.affiliation: Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
authors.forename: Benedictus G K
authors.initials: BG
authors.lastname: Ajayi
authors.affiliation: Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
authors.forename: Ayobade O
authors.initials: AO
authors.lastname: Ogundipe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002387:Cataract Extraction / Q000379:methods*; D004837:Epinephrine / Q000008:administration & dosage; D058447:Eye Pain / Q000175:diagnosis; D005260:Female; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage; D019654:Lens Implantation, Intraocular; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010147:Pain Measurement; D011446:Prospective Studies; D013748:Tetracaine / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D013748:Tetracaine; D008012:Lidocaine; D006821:Hyaluronoglucosaminidase; D004837:Epinephrine
keywords: Extracapsular Cataract Surgery; Manual Small Incision Cataract Surgery; Nigeria; Peribulbar Anesthesia; Posterior Sub-Tenon's Anesthesia