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Sub-Tenon's block reduces both intraoperative and postoperative analgesia requirement in vitreo-retinal surgery under general anaesthesia

Published online by Cambridge University Press:  11 July 2005

A. D. Farmery ,
D. Shlugman ,
R. Rahman  and
P. Rosen
A. D. Farmery
Affiliation:
Oxford Eye Hospital, Department of Anaesthetics, Oxford, UK
D. Shlugman
Affiliation:
Oxford Eye Hospital, Department of Anaesthetics, Oxford, UK
R. Rahman
Affiliation:
Oxford Eye Hospital, Department of Ophthalmic Surgery, Oxford, UK
P. Rosen
Affiliation:
Oxford Eye Hospital, Department of Ophthalmic Surgery, Oxford, UK
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Extract

Summary

Background and objective: We compared the effects of sub-Tenon's local anaesthetic block and placebo on perioperative opioid requirement and cardiovascular stability and on postoperative pain, nausea and vomiting in patients undergoing vitreo-retinal surgery under general anaesthesia.

Methods: We studied 43 patients undergoing vitreo-retinal surgery under general anaesthesia in a randomized double blind study. Patients received a standard general anaesthetic followed by a sub-Tenon's injection of 4–5 mL of either bupivacaine 0.75% or saline. We recorded intraoperative invasive arterial pressure, then the incidence and severity of pain and of nausea and vomiting, for 24 h postoperatively.

Results: In the sub-Tenon's bupivacaine group, there was a significant reduction in the perioperative opioid use and a reduction in the frequency of bradycardia and hypertensive episodes, defined as a rise >25% of baseline for a duration of >3 min. The sub-Tenon's bupivacaine group also had significantly lower pain scores and nausea scores at 12 h, concomitant with a lower consumption of analgesia and antiemetics.

Conclusions: This local anaesthetic technique is effective in vitreo-retinal surgery and can be safely applied to this population of patients regardless of axial length.

Keywords

ANAESTHETIC TECHNIQUES, sub-Tenon's blockOPHTHALMOLOGICAL SURGICAL PROCEDURES, vitrectomy
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 12 , December 2003 , pp. 973 - 978
Copyright
© 2003 European Society of Anaesthesiology

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