Peribulbar anesthesia in vitreoretinal surgery.

BACKGROUND

Retrobulbar anesthesia is considered an effective method of obtaining anesthesia and akinesia in eye surgery. It can give rise to serious complications, however, and these complications could be considerably reduced with peribulbar anesthesia.

METHODS

After using peribulbar anesthesia for 2 years in surgical treatment of the anterior segment, the authors began a study to test its efficacy in posterior segment surgery. Retinal and vitreoretinal surgery with the peribulbar anesthesia technique were performed in 32 consecutive patients.

RESULTS

In all cases anesthesia was complete with one preoperative block. In 2 patients, however, completion of akinesia required a supplemental 2- to 3-cc injection of the anesthetic solution. Surgery was performed with preoperative block only in 31 cases. In the remaining case, a supplemental peribulbar injection of the anesthetic solution was given intraoperatively for pain. In 5 cases (15%) pain at the end of surgery from conjunctiva was controlled by anesthetic drops.

CONCLUSION

It is recommended that this method be used only when the duration of the operation is expected to be brief.