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Abstract #15632 Published in IGR 2-3
Local anaesthetic techniques and pulsatile ocular blood flow
Chang BY; Hee WC; Ling R; Broadway DC; Beigi BBritish Journal of Ophthalmology 2000; 84: 1260-1263
AIM: To compare pulsatile ocular blood flow (POBF) and intraocular pressure (IOP) between eyes of patients receiving either peribulbar (with and without balloon compression) or subconjunctival local anesthesia (LA). METHODS: Thirty eyes of 30 patients undergoing cataract surgery by phacoemulsification were investigated in a study of parallel group design. Ten patients had peribulbar LA and ten minutes' compression with a Honan's balloon (group A). A further ten patients who received peribulbar LA alone (group B) acted as controls for the effects of balloon compression. Ten other patients were given subconjunctival LA (group C). POBF and IOP were measured using a modified Langham pneumatonometer. Three measurements were made in each eye, the first recording immediately before LA, the second one minute after, and the third ten minutes after LA. RESULTS: No significant change in POBF or IOP was recorded in eyes receiving subconjunctival LA. In the peribulbar groups (A and B), there was a drop in median POBF of 252 and 138 &mgr;l/min, respectively, one minute after LA, which was statistically significant in both groups (p < 0.01). By ten minutes, POBF tended to return to baseline levels, but remained significantly reduced in group B (p < 0.05). In addition, there was a significant (p < 0.05) reduction in IOP (mean drop of 4.82 mmHg) in group A following peribulbar LA with balloon compression. CONCLUSIONS: POBF was significantly reduced after peribulbar LA but was unchanged after subconjunctival LA. Balloon compression reduced IOP and improved POBF following peribulbar LA. The findings may have clinical implications in patients with compromised ocular circulation or significant glaucomatous optic neuropathy.
Dr. B.Y. Chang, West of England Eye Unit, Royal Devon and Exeter Hospital, Exeter, UK
Classification:
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
12.17 Anesthesia (Part of: 12 Surgical treatment)
