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Which is Better
Retrobulbar or Sub-Tenon's Capsule Local Anesthesia?
Ahmed A. El-Daba, Atef Zarzor, Ashraf El Zeftawy, Wail E. Mossbah.
Department
of Anesthesia, Faculty of Medicine, Tanta University.
Tanta Med. Sc. J 2007; 2(3):104-108
Article type: Original article
Background/Aim: Subtenon’s capsule injection of
local anesthia is well known in operations of anterior segment but
we are in need for more research in our university to use it in
vitreoretinal surgery. Patients & Methods: Sixty patients received
either retrobulbar or subtenon’s injection (5 ml of 0.75%
ropivacaine) to undergo vitreoretinal surgery. The level of
intraoperative pain was evaluated twice using visual analogue scale.
Also the (start time) was evaluated in both groups. Results: Local
anesthesia in both groups was effective in pain prevention (VAS<1)
immediately after surgery and next morning. Next day VAS was
recorded for remembering pain during operation, in retrobulbar group
(mean = 1.4 + 2.6 median 1) while in subtenon's group (mean = 1.1 +
1.6 with median 1). Start time (time since start of injection until
starting surgery) was evaluated in both groups. In retrobulbar group
(mean = 12 + 4.5 with median 13min.) (P = 0.16). Subtenon's capsule
(mean = 13 + 5.4 with median 14 min.) (P = 0.05). These were
significant difference between both groups. Extra doses of local
anesthesia were evaluated in both groups, in retrobulbar group 11
pat. of 31 needed extra doses, but in subtenon's group only 9 from
29 patients needed extra doses with insignificant difference. As
regard i.v. sedatives, in retrobulbar group about 28 patients needed
i.v. sedation but in subtenon's group only 21 patient needed i.v.
sedation with insignificant difference. Conclusion: subtenon’s
capsule injection is quite effective in pain control as compared to
retrobulbar local anesthia in vitreoretinol surgery.
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