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Abstract #10016 Published in IGR 5-3
Contact versus peribulbar anaesthesia in trabeculectomy: a prospective randomized clinical study
Pablo LE; Pérez-Oliván A; Ferreras A; Polo V; Gómez ML; Honrubia FMActa Ophthalmologica Scandinavica 2003; 81: 486-490
PURPOSE: To compare the pre-, intra- and postoperative pain scores and complication rates in trabeculectomy under contact-topical anesthesia versus peribulbar injection anesthesia. METHODS: A total of 100 patients selected to undergo primary trabeculectomy were randomly allocated to receive either contact or peribulbar anesthesia. Patients were asked to rate their pain levels on a five-point scale for four periods: during the administration of the anesthetic agent, during surgery, immediately after surgery, and 24 hours postoperatively. At the same time, the surgeon was asked to record his subjective assessment of the stress he himself had suffered during the course of the intervention. Surgical parameters, intra- and early postoperative complications were also evaluated. RESULTS: The difference between groups was statistically significant during anesthetic administration. Six patients who received contact-topical anesthesia reported mild discomfort during delivery of the anesthetic agent, while 43 patients complained of mild to severe pain during the injection of bupivacaine (p < 0.001). Thirty-two patients in the contact anesthesia group and 26 in the injected anesthesia group reported no pain during surgery (p = 0.127). Only one patient in each group reported mild pain 30 minutes postoperatively. The authors found no differences between pain rates after surgery. Complications included prolonged chemosis and they also noted that conjunctival hemorrhage occurred more frequently in the peribulbar group than in the contact anesthesia group (p = 0.012). CONCLUSIONS: Both anesthetic methods provided high levels of pain control without additional sedation during surgery. The use of contact-topical anesthesia reduces both pain and the possibility of complications during the administration of anesthetics.
Dr. Luis Pablo, Departamento de Oftalmología, Hospital Universitario Miguel Servet, Paseo Isabel La Católica, 1 y 3, 50009 Zaragoza, Spain. luispablo@eresmas.com
Classification:
12.17 Anesthesia (Part of: 12 Surgical treatment)
