Falcó-Molmeneu E, Sorlí-Clemente E, Ramos-Martí F, Cabrera-Peset A, Andrés-Calvo G, Peris-Molés M
Hospital General de Castellón, España.
Arch Soc Esp Oftalmol. 2007 Mar;82(3):147-52. doi: 10.4321/s0365-66912007000300006.
To evaluate peroperative pain management using a flexible spinal anesthesia catheter introduced into the retrobulbar space which allows injections of local anesthetics for vitreoretinal surgery.
Twenty-five patients who underwent vitreoretinal surgery receiving retrobulbar anesthesia with 3.5 ml ropivacaine 0.75%. After injection, a catheter with spinal needle 22G x 1 1/2 (40 x 0.7 mm) was introduced to the retrobulbar muscle cone. The needle was withdrawn and the catheter was fixed. When the patient started to feel pain (grade 3 or higher), 2 ml ropivacaine 0.75% was administrated through the catheter during surgery or 2 ml ropivacaine 0.2% in the postoperative period. The catheter was removed 24- 48h later.
During surgery, 1 patient (4%) received a re-injection of 2 ml ropivacaine 0.75% because of pain. Three patients (12%) experienced pain of grade 3 or higher in the postoperative period and needed re-injection of 2 ml ropivacaine 0.2%. Re-injections were an effective method to achieve analgesia. Adverse effects were not noticed.
The retrobulbar catheter technique is a procedure which allows multiple re-injections of local anesthetics; it provides adequate analgesia during surgery and rapid, effective and safe postoperative pain management.
