1
|
Scampoli A, Governatori L, Bernardinelli P, Picardi SM, Culiersi C, Caporossi T. Inverted ILM Flap for a Needle Injury to the Macula after Peribulbar Anaesthesia: A Case Report and Literature Review. Life (Basel) 2023; 13:1390. [PMID: 37374172 DOI: 10.3390/life13061390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Globe perforation following peribulbar anesthetic injection is a rare but dreaded complication that often results in poor visual outcomes. This case report is on a female patient who sustained vitreous hemorrhage, retinal detachment, and macular breaks due to a peribulbar block administered in the setting of cataract extraction. The retina was repaired with pars plana vitrectomy, endolaser of the peripheral retinal break only, and an internal limiting membrane inverted flap for the macular breaks to avoid the endolaser on the macular area, achieving stable visual outcomes. The authors discussed various modes of local anesthesia for vitreoretinal surgery, risks for globe perforations, and how to approach retinal detachment secondary to needle perforations, which are complex cases at high risk for proliferative vitreoretinopathy. Early recognition and intervention in eyes with an inadvertent perforation can lead to a good outcome. Eyes with a longer axial length, superior, and multiple perforations are at higher risk of developing complications such as retinal detachment and vitreous hemorrhage. Complications such as retinal detachment, macular injury, and vascular occlusion are risk factors for poor prognosis.
Collapse
Affiliation(s)
- Alessandra Scampoli
- Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy
| | - Lorenzo Governatori
- Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy
| | - Patrizio Bernardinelli
- Catholic University of the Sacred Heart, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Stefano Maria Picardi
- Ophthalmology Unit, ASST Melegnano e Della Martesana, 20070 Vizzolo Predabissi, Italy
| | - Carola Culiersi
- Catholic University of the Sacred Heart, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Tomaso Caporossi
- Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy
- Catholic University of the Sacred Heart, 00168 Rome, Italy
| |
Collapse
|
2
|
Kumar C, Seet E, Chua A. Updates in ophthalmic anaesthesia in adults. BJA Educ 2023; 23:153-159. [PMID: 36960436 PMCID: PMC10028395 DOI: 10.1016/j.bjae.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/17/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- C.M. Kumar
- Khoo Teck Puat Hospital, Yishun, Singapore
- Newcastle University Medical School, EduCity, Johor, Malaysia
| | - E. Seet
- Khoo Teck Puat Hospital, Yishun, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - A.W.Y. Chua
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| |
Collapse
|
3
|
Chua AW, Chua MJ, Harrisberg BP, Kumar CM. Inexpensive home-assembled human skull model for training and learning the peribulbar block technique. Anaesth Intensive Care 2022; 50:400-402. [PMID: 36076352 DOI: 10.1177/0310057x211063892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alfred Wy Chua
- Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Matthew J Chua
- Department of Intensive Care Medicine, 8539Westmead Hospital, Westmead, Australia
| | - Brian P Harrisberg
- Department of Ophthalmology, 2205Royal Prince Alfred Hospital, Camperdown, Australia
| | - Chandra M Kumar
- Department of Anaesthesia, Khoo Teck Puat Hospital, Singapore.,Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Medical School, Johor, Malaysia
| |
Collapse
|
4
|
Xu Q, Ren M, Guan J, Shi G, Ni Y, Luan J. Efficacy and safety of trans-sub-Tenon's retrobulbar anesthesia for pars plana vitrectomy: a randomized trial. BMC Ophthalmol 2022; 22:289. [PMID: 35773662 PMCID: PMC9248172 DOI: 10.1186/s12886-022-02507-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
AIM To compare the efficacy and safety of trans-sub-Tenon's ciliary nerve block anesthesia and transcutaneous retrobulbar anesthesia in patients undergoing pars plana vitrectomy (PPV). METHODS A prospective, randomized, double-blinded clinical trial was conducted at Zhongda Hospital, Affiliated with Southeast University, from February 2021 to October 2021. Patients undergoing PPV were randomly allocated into two groups: the trans-sub-Tenon's anesthesia group (ST group) and the retrobulbar anesthesia group (RB group) in the ratio of 1:1. The ST group received 2 ml ropivacaine through the Tenon capsule to the retrobulbar space, while the RB group received 2 ml ropivacaine via transcutaneous retrobulbar injection. Visual analog score (VAS) was used to evaluate pain during the whole process, including during anesthesia implementation, intraoperatively and on the first day after the operation. Movement evaluation (Brahma scores) and anesthesia-related complications were also noted. RESULTS Finally, a total of 120 patients were included in the study (60 in the ST group and 60 in the RB group). There were no significant differences in baseline patient characteristics or surgical features between the two groups. The VAS pain scores for anesthesia implementation were 0.52 ± 0.47 in the ST group and 1.83 ± 0.87 in the RB group (P < 0.001). The VAS scores during the operation were 0.53 ± 0.49 in the ST group and 1.48 ± 1.02 in the RB group (P < 0.001) and those on the first day after the operation were 0.37 ± 0.38 in the ST group and 0.81 ± 0.80 in the RB group (P = 0.002). No patients required supplemental intravenous anesthesia intraoperatively. The Brahma movement scores were 0.70 ± 1.64 in the ST group (scores ranging from 0 to 8) and 2.38 ± 3.15 in the RB group (ranging from 0 to 12) (P = 0.001). Forty-two patients in each group received laser photocoagulation during surgery. Fifteen patients (36%) in the ST group could not see the flashes of the laser, compared to 8 patients (19%) in the RB group (P = 0.087). No serious sight-threatening or life-threatening complications related to anesthesia were observed in either group. CONCLUSIONS For PPV, trans-sub-Tenon's ciliary nerve block anesthesia was more effective in controlling pain than transcutaneous retrobulbar anesthesia during the whole surgery process, including during anesthesia implementation, intraoperatively and on the first day after the operation. Additionally, it could achieve better effect of akinesia and was relatively safe. Trans-sub-Tenon's anesthesia could be considered an alternative form of local anesthesia during vitreoretinal procedures. TRIAL REGISTRATION The study protocol has been registered at ChiCTR.org.cn on February 2021 under the number ChiCTR2100043109 .
Collapse
Affiliation(s)
- Qian Xu
- Department of Ophthalmology, Zhongda Hospital, Southeast University, Nanjing, 210009, Jiangsu Province, China.,School of Medicine, Southeast University, Nanjing, 210009, China
| | - Meiqing Ren
- Department of Ophthalmology, Zhongda Hospital, Southeast University, Nanjing, 210009, Jiangsu Province, China.,School of Medicine, Southeast University, Nanjing, 210009, China
| | - Juanjuan Guan
- Department of Ophthalmology, Zhongda Hospital, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Guihong Shi
- Department of Ophthalmology, Zhongda Hospital, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Yan Ni
- Department of Ophthalmology, Zhongda Hospital, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Jie Luan
- Department of Ophthalmology, Zhongda Hospital, Southeast University, Nanjing, 210009, Jiangsu Province, China. .,School of Medicine, Southeast University, Nanjing, 210009, China.
| |
Collapse
|
5
|
Bartholomew KJ, Smith LJ, Bentley E, Lasarev MR. Retrospective analysis of complications associated with retrobulbar bupivacaine in dogs undergoing enucleation surgery. Vet Anaesth Analg 2020; 47:588-594. [PMID: 32653165 DOI: 10.1016/j.vaa.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate complications associated with, and without, bupivacaine retrobulbar local anesthesia in dogs undergoing unilateral enucleation surgery. STUDY DESIGN Retrospective, observational study. ANIMALS A total of 167 dogs underwent unilateral enucleation surgery via a transpalpebral approach. METHODS Records from 167 dogs that underwent unilateral enucleation surgery that did (RB) or did not (NB) include retrobulbar bupivacaine anesthesia were reviewed, including anesthetic record, daily physical examination records, surgery report, patient discharge report and patient notes within 14 days of the surgery. Specific complications and severity were compared between RB and NB using the Wilcoxon rank-sum test. A 'complication burden' (0-5) comprising five prespecified complications was assigned and tested using rank-sum procedures. Statistical significance was set to 0.05. RESULTS Group RB included 97 dogs and group NB 70 dogs. Dogs in NB had a 17.0 percentage points (points) greater risk for a postoperative recovery complication (38.6% versus 21.6%; 95% confidence interval: 3.0-30.6 points; p = 0.017). There was inconclusive evidence that dogs in group RB had a lower risk of requiring perioperative anticholinergic administration (12.4% versus 22.9%; 10.5 points; p = 0.073). Other complications were similar between groups RB and NB with risks that differed by <10 points. The risk of hemorrhage was similar between groups RB (22.7%) and NB (20.0%) with no significant difference in the level of severity (p = 0.664). CONCLUSIONS AND CLINICAL RELEVANCE In this retrospective study, the use of retrobulbar bupivacaine for enucleation surgery in dogs was not associated with an increased risk of major or minor complications.
Collapse
Affiliation(s)
- Kyle J Bartholomew
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA
| | - Lesley J Smith
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA.
| | - Ellison Bentley
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA
| | - Michael R Lasarev
- Department of Biostatistics and Medical Informatics, University of Wisconsin - Madison, Madison, WI, USA
| |
Collapse
|
6
|
Kumar CM, Seet E, Eke T, Irwin MG, Joshi GP. Peri‐operative considerations for sedation‐analgesia during cataract surgery: a narrative review. Anaesthesia 2019; 74:1601-1610. [DOI: 10.1111/anae.14845] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2019] [Indexed: 12/30/2022]
Affiliation(s)
- C. M. Kumar
- Department of Anaesthesiology Khoo Teck Puat Hospital SingaporeSingapore
| | - E. Seet
- Department of Anaesthesiology Khoo Teck Puat Hospital SingaporeSingapore
| | - T. Eke
- Department of Ophthalmology Norfolk and Norwich University Hospitals NorwichUK
| | - M. G. Irwin
- Department of Anaesthesiology The University of Hong Kong Hong Kong Special Administrative Region Hong Kong China
| | - G. P. Joshi
- Department of Anesthesiology and Pain Management University of Texas Southwestern Medical Center Dallas TX USA
| |
Collapse
|
7
|
A call to action - Why European anaesthesiologists and ophthalmic surgeons should join efforts in a common society. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2019. [DOI: 10.1016/j.tacc.2018.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
8
|
Shilo-Benjamini Y. A review of ophthalmic local and regional anesthesia in dogs and cats. Vet Anaesth Analg 2019; 46:14-27. [DOI: 10.1016/j.vaa.2018.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/19/2018] [Accepted: 10/20/2018] [Indexed: 12/17/2022]
|
9
|
Shilo-Benjamini Y, Pascoe PJ, Maggs DJ, Hollingsworth SR, Strom AR, Good KL, Thomasy SM, Kass PH, Wisner ER. Retrobulbar vs peribulbar regional anesthesia techniques using bupivacaine in dogs. Vet Ophthalmol 2018; 22:183-191. [DOI: 10.1111/vop.12579] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yael Shilo-Benjamini
- Koret School of Veterinary Medicine; The Robert H. Smith Faculty of Agriculture, Food and Environment; The Hebrew University of Jerusalem; Rehovot Israel
| | - Peter J. Pascoe
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - David J. Maggs
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Steven R. Hollingsworth
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Ann R. Strom
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Kathryn L. Good
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Sara M. Thomasy
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Philip H. Kass
- Department of Population Health and Reproduction; School of Veterinary Medicine; University of California; Davis CA USA
| | - Erik R. Wisner
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| |
Collapse
|
10
|
Behera UC, Panda L, Gupta S, Modi RR. Subconjunctival hemorrhage and vision loss after regional ocular anesthesia. Int Ophthalmol 2017; 38:1309-1312. [PMID: 28434070 DOI: 10.1007/s10792-017-0539-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 04/17/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To report two cases of retinal vascular occlusion and associated subconjunctival hemorrhage in needle optic nerve injury during local bulbar anesthesia. METHODS Surgical records of these two subjects who presented with acute vision loss after cataract extraction were studied, and systemic workup and ocular imaging were carried out to establish the cause. RESULTS Computerized tomography showed evidence of optic nerve injury. CONCLUSION Subconjunctival hemorrhage could be an associated clinical finding in hypodermic needle injury-related retinal vascular occlusion during ocular anesthesia.
Collapse
Affiliation(s)
| | - Lapam Panda
- L V Prasad Eye Institute, Patia, Bhubaneswar, Odisha, 751024, India
| | - Sumi Gupta
- Srikrishna Eye Institute, N-71 Shivalik Nagar, Haridwar, Uttarakhand, 249403, India
| | | |
Collapse
|
11
|
Stadler S, Dennler M, Hetzel U, Del Chicca F, Hoey S, Spiess BM, Voelter K, Pot SA. Sub-Tenon's injection in equine cadaver eyes: MRI visualization of anesthetic fluid distribution and comparison of two different volumes. Vet Ophthalmol 2016; 20:488-495. [PMID: 28008696 DOI: 10.1111/vop.12452] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the localization and distribution of two different anesthetic fluid volumes around equine cadaver eyes to determine an appropriate volume for a single sub-Tenon's injection in horses. PROCEDURE A single sub-Tenon's injection of 2% lidocaine was performed in 10 equine cadaver heads (20 eyes) using two different volumes (7 mL on one side and 10 mL on the opposite side). The posterior circular distribution of the anesthetic was quantified in sagittal, dorsal, and transverse MRI (T2W-TSE) sequences and evaluated independently by three board-certified radiologists. The distribution of the two fluid volumes was compared via a paired Student's t-test. The interobserver reliability was evaluated via a Kruskal-Wallis test. RESULTS Extension of the injection fluid was observed along the dorsal and temporal quadrants of the globe within the subconjunctival space, the anterior and posterior sub-Tenon's space, and into the muscle sheaths along the extraocular muscles. Accumulation of anesthetic fluid directly surrounding the optic nerve was detected in three of 20 cadaver eyes. Circular distribution of the 7 and 10 mL anesthetic volumes was not significantly different (P = 0.849). More retrograde leakage of the anesthetic was observed using the 10 mL volume. Evaluation of interobserver reliability revealed no significant differences between observers (P = 0.21-0.92). CONCLUSIONS Sub-Tenon's anesthesia can have potential as an alternative to retrobulbar anesthesia for ophthalmic surgeries in equines. A 7- to 10-mL injection volume should be appropriate based on the results of this study. The distribution of the anesthetic solution in live tissues, the clinical effects, and the potential for complications will have to be evaluated in vivo.
Collapse
Affiliation(s)
- Silvia Stadler
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Winterthurerstrasse 260, Zurich, CH-8057, Switzerland
| | - Matthias Dennler
- Diagnostic Imaging Unit, Vetsuisse Faculty, Department for Small Animals, University of Zurich, Zurich, CH-8057, Switzerland
| | - Udo Hetzel
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, CH-8057, Switzerland
| | - Francesca Del Chicca
- Diagnostic Imaging Unit, Vetsuisse Faculty, Department for Small Animals, University of Zurich, Zurich, CH-8057, Switzerland
| | - Sèamus Hoey
- Diagnostic Imaging Unit, Vetsuisse Faculty, Department for Small Animals, University of Zurich, Zurich, CH-8057, Switzerland
| | - Bernhard M Spiess
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Winterthurerstrasse 260, Zurich, CH-8057, Switzerland
| | - Katrin Voelter
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Winterthurerstrasse 260, Zurich, CH-8057, Switzerland
| | - Simon A Pot
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Winterthurerstrasse 260, Zurich, CH-8057, Switzerland
| |
Collapse
|
12
|
Eke T. Preoperative Preparation and Anesthesia for Trabeculectomy. J Curr Glaucoma Pract 2016; 10:21-35. [PMID: 27231416 PMCID: PMC4875731 DOI: 10.5005/jp-journals-10008-1198] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 12/23/2015] [Indexed: 11/29/2022] Open
Abstract
Preoperative preparation should improve the likelihood of successful trabeculectomy surgery. The team can reconsider the appropriateness of the proposed surgery, and steps can be taken to maximize the chance of a good outcome. For example, adjustments to anti-hypertensive or anti-coagulant medications may be made, and topical ocular medications adjusted. Choice of anesthesia technique is of particular relevance to the trabeculectomy patient. Some anesthesia techniques are more likely to have serious complications, and glaucoma patients may be at higher risk of some sight-threatening complications, because the optic nerve is already damaged and vulnerable. Posterior placement of local anesthesia (retrobulbar, peribulbar, posterior sub-Tenon's techniques) could potentially damage the optic nerve, and thereby cause "wipe-out" of vision. Anesthesia technique may influence the likelihood of vitreous bulge and surgical difficulty. Regarding long-term control of intraocular pressure, there is no good evidence to indicate that any particular anesthesia technique is better than another. There is little high-quality evidence on this topic. The author's preferred technique for trabeculectomy is subconjunctival-intracameral anesthesia without sedation. How to cite this article: Eke T. Preoperative Preparation and Anesthesia for Trabeculectomy. J Curr Glaucoma Pract 2016; 10(1):21-35.
Collapse
Affiliation(s)
- Tom Eke
- Consultant, Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK
| |
Collapse
|
13
|
Comparison of Needle Path, Anesthetic Dispersion, and Quality of Anesthesia in Retrobulbar and Peribulbar Blocks. Reg Anesth Pain Med 2016; 41:37-42. [DOI: 10.1097/aap.0000000000000340] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Chen WQ, Jhanji V, Chen HY, Zhang GH, Hou P. Visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery. Int J Ophthalmol 2014; 7:860-3. [PMID: 25349807 DOI: 10.3980/j.issn.2222-3959.2014.05.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/02/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To investigate the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery. METHODS In this prospective case series, consecutive patients who underwent combined phacoemulsification and pars plana vitrectomy (PPV) under sub-Tenon anesthesia between October 2008 and September 2009 were enrolled. The patients were asked whether they could see the light of the operating microscope or not between various surgical steps with their contralateral eye being covered. RESULTS A total of 163 eyes of 163 patients were enrolled in this study. After their contralateral eyes were covered, 152 (93.3%) patients said that they could not see any light at least during one of the surgical steps. All eyes recovered to at least light perception on the first postoperative day. The incidence of no light perception during the surgery was not related to demographic factors, including age, gender, or type of ocular diseases. CONCLUSION The incidence of no light perception during combined phacoemulsification and vitrectomy under sub-Tenon anesthesia was high in our study. Patients should be duly informed about this temporary but potential intraoperative event.
Collapse
Affiliation(s)
- Wei-Qi Chen
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - Vishal Jhanji
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China ; Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong, China
| | - Hao-Yu Chen
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - Gui-Hua Zhang
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - Ping Hou
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| |
Collapse
|
15
|
Shilo‐Benjamini Y, Pascoe PJ, Maggs DJ, Kass PH, Wisner ER. Retrobulbar and peribulbar regional techniques in cats: a preliminary study in cadavers. Vet Anaesth Analg 2013; 40:623-31. [DOI: 10.1111/vaa.12060] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 04/17/2013] [Indexed: 11/29/2022]
|
16
|
McCloud C, Harrington A, King L. A qualitative study of regional anaesthesia for vitreo-retinal surgery. J Adv Nurs 2013; 70:1094-104. [PMID: 24102774 DOI: 10.1111/jan.12263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2013] [Indexed: 11/30/2022]
Abstract
AIM The aim of this research was to collect experiential knowledge about regional ocular anaesthesia - an integral component of most vitreo-retinal surgery. BACKGROUND Anaesthesia for vitreo-retinal surgery has predominantly used general anaesthesia, because of the length and complexity of the surgical procedure. However, recent advances in surgical instrumentation and techniques have reduced surgical times; this decision has led to the adoption of regional ocular anaesthesia for vitreo-retinal day surgery. Although regional ocular anaesthesia has been studied from several perspectives, knowledge about patients' experience of the procedure is limited. DESIGN An interpretive qualitative research methodology underpinned by Gadamer's philosophical hermeneutics. METHODS Eighteen participants were interviewed in-depth between July 2006-December 2007 following regional ocular anaesthesia. Interview data were thematically analysed by coding and grouping concepts. FINDINGS Four themes were identified: 'not knowing': the time prior to the experience of a regional eye block; 'experiencing': the experience of regional ocular anaesthesia; 'enduring': the capacity participants displayed to endure regional ocular anaesthesia with the hope that their vision would be restored; and 'knowing': when further surgery was required and past experiences were recalled. CONCLUSIONS The experience of regional ocular anaesthesia had the capacity to invoke anxiety in the participants in this study. Many found the experience overwhelming and painful. What became clear was the participant's capacity to stoically 'endure' regional ocular anaesthesia, indicating the value people placed on visual function.
Collapse
Affiliation(s)
- Christine McCloud
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | | | | |
Collapse
|
17
|
Brainstem anaesthesia revisited: Mechanism, presentation and management. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2013. [DOI: 10.1016/j.tacc.2013.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|