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One point low volume peribulbar anaesthesia versus retrobulbar anaesthesia. A prospective clinical trial

NS Athanikar, VB Agrawal
H.B.M.G. Hospital, Borivli(W), Mumbai, India
Correspondence Address:
N S Athanikar
H.B.M.G. Hospital, Borivli(W), Mumbai 
India

PMID: 1916978

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  Abstract |   | |
A prospective trial was conducted on 142 patients who underwent cataract surgery,to compare the efficacy of a single point, low volume peribulbar with that of retrobulbar anaesthesia. It was found that peribulbar anaesthesia is as efficacious as retrobulbar anaesthesia without the associated complications. It also avoids the facial block used by most ophthalmologists to supplement a retrobulbar block, thus markedly reducing the post-operative patient discomfort as well as thetotal volume of anaesthetic used.

Keywords: Peribulbar, Retrobulbar Anaesthesia, Cataract Surgery.

How to cite this article:
Athanikar NS, Agrawal VB. One point low volume peribulbar anaesthesia versus retrobulbar anaesthesia. A prospective clinical trial. Indian J Ophthalmol 1991;39:48-9 |

How to cite this URL:
Athanikar NS, Agrawal VB. One point low volume peribulbar anaesthesiaversus retrobulbar anaesthesia. A prospective clinical trial. Indian J Ophthalmol [serial online] 1991 [cited 2012 Dec 4];39:48-9. Available from: http://www.ijo.in/text.asp?1991/39/2/48/24472 |

  Introduction |   | |

Various studies have been documented to emphasise the salientfeatures of retrobulbar anaesthesia and some for peribulbar anaesthesia in ophthalmology. However, little data isavailable comparing the two. The present study was designed as a single blind prospective trial to compare the two modes of anaesthesia for cataract surgery.

In the past, most methods of peribulbar anaesthesia were multipoint and thus cumbersome [1]. We have used the one point, low volume approach of Weiss et al (1989). Thus in addition to proving the efficacy of peribulbar anaesthesia incomparison with retrobulbar anaesthesia, this study also proves the utility of the single point, low volume method. This method of anaesthesia is advantageous in that it eliminates all the various complications of retrobulbar anaesthesia (eg. retrobulbar haemorrhage, central artery occlusion, ocular perforation, subarachnoid injection, brain stem anaesthesia, cardiopulmonary arrest) and thepostoperative pain and edema of a facial block [2],[3],[4],[5],[6],[7].

  MATERIAL & METHODS |   | |

142 patients who underwent cataract surgery were randomly divided into 2 groups with the aid of a randomisation chart.

Group A: Retrobulbar anaesthesia. Group B: Peribulbar anaesthesia.

The administration and evaluation were done by separate individuals.

Mixture administered:

GroupA: 5 cc Lignocaine (2%) + 1:200000 Adrenaline + 150 IU Hyaluronidase injected with a 23 no. 3.75 cm needle placed at the junction of the medial 2/3 and the lateral 1/3 of the inferior orbital rim and directed backwards and upwards. Aspiration was done before injection to check I.V. penetration.

Group B: 5cc Lignocaine (2%) + 1:200000 Adrenaline + 150 IU Hyaluronidase injected with a 25 no.1.5 cm needle in the same manner as retrobulbar injection except that it was directed straight down with the needle buried upto the hub at the skin.

No facial blocks or additional injections for lid akinesia were used. Following the ocular injection massage was done by applying a super pinky ball to exert uniform pressure for 10 minutes with intermittent release of pressure in both groups ofpatients.

At the end of 10 minutes the eyes were evaluated for:

1) Lid akinesia

2) Globe akinesia

3) Globe anaesthesia

Each of the above was graded on a scale of 0 to +++ as follows:

0 Akinesia/Anaesthesia inadequate to continue.

+ Akinesia/Anaesthesia not ideal but adequate

to proceed

++ Akinesia/Anaesthesia not ideal but more than

adequate proceed.

+++ Total...