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Surgeons, patients report better results using sub-Tenon's block anesthesia for phaco
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Compared with topical anesthesia, using sub-Tenon's block anesthesia during phacoemulsification cataract surgery can achieve more significant anesthesia and analgesia, lead to more favorable surgical conditions and enhance satisfaction, according to a prospective study by researchers in Portugal.
P.A. Rodrigues, MD, and colleagues at Pedro Hispano Hospital in Matosinhos compared surgical conditions, potential complications, and patient and surgeon satisfaction after performing phaco on 59 patients using either topical anesthesia or sub-Tenon's block anesthesia. Specifically, the surgeons randomly assigned 26 patients to receive topical anesthesia and 33 patients to receive sub-Tenon's block anesthesia. There was no statistically significant clinical or anatomic differences between the groups; however, patient collaboration was better in the sub-Tenon's block group.
Patient satisfaction was evaluated using the Iowa Satisfaction with Anesthesia Scale (ISAS).
The investigators observed an average post-anesthetic IOP rise of 2.2 mm Hg in the sub-Tenon's block anesthesia group that normalized at 24-hours.
No IOP spikes were observed in the topical anesthesia group, the authors noted.
Subconjunctival hemorrhage and chemosis were more prevalent in the sub-Tenon's block anesthesia group; visual acuity improvement was similar in both groups.
Both surgeon and patient subjective satisfaction was higher using sub-Tenon's block anesthesia.
The final ISAS scores were 1.87 in the topical anesthesia group and 2.71 in the sub-Tenon's block anesthesia group (P < .005), according to the study, published in the May-June issue of European Journal of Ophthalmology.