Comparing the effectiveness and safety of sub-tenon's anaesthesia and peribulbar anaesthesia in anterior segment surgery

Abstract

Introduction Proper anaesthetic management is an integral part of any successful eye surgery. Patient comfort during the operative procedure is the single most important factor. The search for surgical adjutants to achieve anaesthesia and akinesia has produced many advances, easing the ordeal of surgery for both the patient and the surgeon. Methods 500 patients undergoing anterior segment surgery after obtaining consent were included in the study. Out of which, 250 were administered peribulbar while 250 were given sub-Tenon's anaesthesia randomly. Pain during administration of anaesthesia, during surgery and 4 h after surgery was graded on a visual analogue pain scale and compared for both the techniques. Subconjuntival haemorrhage, chemosis, akinesia after administration of anaesthesia and positive pressure during surgery were also compared. Patients were followed up for 6 weeks postoperatively. Results The sub-Tenon's anaesthesia procedure was painless for 25.2% of the patients; The peribulbar anaesthesia procedure was painless for 8.91% of the patients. The anaesthetic block was very efficient with both the techniques. Pain during anaesthetic administration was lower for sub-Tenon's anaesthesia (63, 25.2%). Chemosis, sub conjunctival haemorrhage was more common with sub-Tenon's anaesthesia. Akinesia was better with peribulbar anaesthesia. Conclusion The volume of anaesthetic injected is more with peribulbar anaesthesia when compared to sub-Tenon's anaesthesia. Pain during anaesthetic administration is lower with sub-Tenon's anaesthesia compared with the peribulbar technique. Chemosis and subconjunctival haemorrhage are more frequent with sub-Tenons anaesthesia.