An audit of peribulbar blockade using 15 mm, 25 mm and 37.5 mm needles, and sub-Tenon's injection*
Open Access
- 19 July 2004
- journal article
- research article
- Published by Wiley in Anaesthesia
- Vol. 59 (8), 775-780
- https://doi.org/10.1111/j.1365-2044.2004.03799.x
Abstract
The efficacy of peribulbar anaesthesia performed with short, medium and long needles, with sub-Tenon's injection as a control, was audited. Two hundred patients undergoing cataract surgery underwent peribulbar injection using 25G needles of the following lengths: 15 mm, 25 mm or 37.5 mm. Sub-Tenon's injections were performed with a curved 25-mm sub-Tenon anaesthesia cannula. The injection technique, ocular akinesia and analgesia scoring system, and supplementary injection protocols were standardised. After initial injections of local anaesthetic via the sub-Tenon's cannula or with 37.5 mm, 25 mm and 15 mm needles, supplementation was required in one (2%), 13 (26%), 22 (44%) and 32 (64%) of patients, respectively; the total number of supplementary injections required were 1, 16, 35 and 47, respectively. It is concluded that the efficacy of peribulbar anaesthesia depends upon the proximity of the deposition of local anaesthetic solution either to the globe or orbital apex. These data justify the classification of peribulbar anaesthesia into: circum-ocular (sub-Tenon's, episcleral), peri-ocular (anterior, superficial); peri-conal (posterior, deep) and apical (ultra-deep) for teaching purposes.This publication has 28 references indexed in Scilit:
- Comparison of lignocaine 2% with adrenaline, bupivacaine 0.5% with or without hyaluronidase and a mixture of bupivacaine, lignocaine and hyaluronidase for peribulbar block analgesiaActa Anaesthesiologica Scandinavica, 2001
- Ophthalmic Regional Anesthesia: Medial Canthus Episcleral (Sub-Tenon) Anesthesia Is More Efficient than Peribulbar AnesthesiaAnesthesiology, 2000
- Regional anesthesia for ophthalmic surgery performed by single episcleral (sub-tenon) injection: A 802 cases experienceRegional Anesthesia & Pain Medicine, 1999
- Sub-Tenon's anaesthesia: an efficient and safe techniqueBritish Journal of Ophthalmology, 1997
- Medial Canthus (Caruncle) Single Injection Periocular AnesthesiaAnesthesia & Analgesia, 1996
- The effect of hyaluronidase on peribulbar blockAnaesthesia, 1994
- Retrobulbar Hemorrhage After 12,500 Retrobulbar BlocksAnesthesia & Analgesia, 1993
- A comparison of percutaneous and perconjunctival routes of administration of peri-ocular anaesthesia for day case cataract surgeryAnaesthesia, 1993
- A new local anesthesia technique for cataract extraction by one quadrant sub-Tenon's infiltration.British Journal of Ophthalmology, 1992
- Respiratory arrest after retrobulbar blockActa Ophthalmologica, 1988