Reichstein David A, Warren Clinton C, Han Dennis P, Wirostko William J
Ophthalmic Surg Lasers Imaging Retina. 2016 Jan;47(1):55-9. doi: 10.3928/23258160-20151214-08.
To evaluate the safety and efficacy of a blunt sub-Tenon's cannula for local anesthesia before vitreoretinal surgery compared to a sharp retrobulbar needle.
Retrospective, comparative study of all patients undergoing vitreoretinal surgery at the Medical College of Wisconsin between August 2009 and November 2013. Institutional review board approval was obtained.
Of 940 surgeries performed with a sub-Tenon's cannula, 99% (938 of 940) were completed. Of the 771 surgeries performed with a sharp retrobulbar needle, 99% (770 of 771) were completed. Factors associated with use of a sharp retrobulbar needle over sub-Tenon's cannula were presence of prior scleral buckle (P < .01) and inclusion of scleral buckle placement in the procedure (P < .01). No case of globe perforation, severe retrobulbar hemorrhage, or severe conjunctival chemosis was observed in either group.
Blunt sub-Tenon's cannula appears as effective and safe as a sharp retrobulbar needle for local anesthesia during vitreoretinal surgery. Vitreoretinal surgeons may wish to consider a blunt sub-Tenon's cannula for local surgical anesthesia.
比较钝性巩膜下套管与锐利的球后注射针用于玻璃体视网膜手术局部麻醉的安全性和有效性。
对2009年8月至2013年11月在威斯康星医学院接受玻璃体视网膜手术的所有患者进行回顾性比较研究。获得了机构审查委员会的批准。
使用巩膜下套管进行的940例手术中，99%（940例中的938例）完成。使用锐利球后注射针进行的771例手术中，99%（771例中的770例）完成。与使用锐利球后注射针而非巩膜下套管相关的因素是既往存在巩膜扣带（P <.01）以及手术中包括巩膜扣带植入（P <.01）。两组均未观察到眼球穿孔、严重球后出血或严重结膜水肿的病例。
钝性巩膜下套管在玻璃体视网膜手术局部麻醉中似乎与锐利球后注射针一样有效和安全。玻璃体视网膜外科医生可能希望考虑使用钝性巩膜下套管进行局部手术麻醉。
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