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Abstract #10175 Published in IGR 6-1
Subconjunctival anaesthesia using cocaine or mepivacaine for cyclocryotherapy in advanced glaucoma
Mielke J; Schlote TKlinische Monatsblätter für Augenheilkunde 2004; 221: 24-28
BACKGROUND: Retro- and peribulbar anesthesia are the standard procedures for cyclodestructive surgery. Because these methods of anesthesia may further compromise optic nerve function, especially in advanced glaucoma, subconjunctival anesthesia was evaluated as an alternative procedure in cyclocryotherapy. PATIENTS AND METHODS: 1. In 2001, in order to evaluate the current methods of anesthesia, a questionnaire was sent to all university eye clinics in Germany. 2. A prospective, consecutive study concerning cyclocryotherapy in advanced glaucoma was started using subconjunctival anesthesia with 5% cocaine or, alternatively, 2% mepivacaine in 25 eyes of 25 patients in each group. Pain during cyclocryotherapy was recorded using a ten-point rating-scale (1 = no pain, 10 = intolerably severe pain), and adverse events were also recorded. RESULTS: 88.6% of the university eye clinics in Germany replied to the questionnaire. In 2001, cyclocryotherapy was performed in 80.6% of the university eye clinics in Germany (not including Tubingen), 16.1% of these used cyclocryotherapy solely for the treatment of advanced glaucoma. Using 5% cocaine for subconjunctival anesthesia, 92% of patients experienced no pain and 8% reported very mild pain during cyclocryotherapy. One patient reported nausea, four dryness of the mouth. After anesthesia with mepivacaine, 80% experienced no pain, 12% very mild pain, and 8% mild pain. There were no systemic side effects. CONCLUSIONS: Most patients experienced no pain during cyclocryotherapy using subconjunctival anesthesia with cocaine or mepivacaine. Therefore, risks and side effects of retro- or parabulbar anesthesia can be successfully avoided by this simple modification.LA: German
Dr. J. Mielke, Universitats-Augenklinik Tubingen, Abteilung I: Erkrankungen des vorderen und hinteren Augenabschnitts, Tubingen, Germany. jorgemielke@web.de
Classification:
12.11 Cyclodialysis (Part of: 12 Surgical treatment)
12.17 Anesthesia (Part of: 12 Surgical treatment)