A Randomised, Controlled, Trial of Sub-Tenon’s Versus Peribulbar Anaesthesia in Manual Small Incision Cataract Surgery

Abstract

Background and Objectives ABSTRACT Peribulbar anaesthesia provides excellent analgesia, akinesia and is used world wide for performing cataract surgery. However, it is rarely associated with devastating complications. Sub-Tenon’s anaesthesia is safe method of delivering anaesthesia as it avoids the introduction of sharp needles into the orbit. The objectives of the present study were to evaluate the comparative efficacy and safety of sub- Tenon’s anaesthesia and peribulbar anaesthesia, during manual small incision cataract surgery. Methods The present randomized controlled trial was conducted among 100 patients undergoing manual small incision cataract surgery at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2008 to December 2008. The patients were randomly allocated to peribulbar group ( 50 patients) and Sub -Tenon’s group ( 50 patients ) . The efficacy was measured by akinesia of extraocular muscles, akinesia of lid, pain assessed during injection, intraoperative and after surgery, effects on intraocular pressure and complications of peribulbar and sub- Tenon’s block. Results Both the techniques achieved complete akinesia at the end of 15 minutes following the administration of anaesthesia. Both the techniques were free from sight or life threatening complications. In Sub-Tenon’s anaesthesia the onset of akinesia was faster and statistically significant number of patients achieved complete akinesia X in the first five minutes ( p=0.048) . It provided remarkable analgesia from the time of administration till four hours postoperative period. Only minor complications like chemosis and sub-conjuctival haemorrhage occurred. The incidence of chemosis was more in peribulbar anaesthesia and sub-conjunctival haemorrhage was more in sub- Tenon’s anaesthesia. Conclusion Sub-Tenon’s anaesthesia is a preferred alternative to peribulbar anaesthesia during manual small incision cataract surgery.