A comparative study of sub-tenon's versus peribulbar anesthesia for small incision cataract surgery

Abstract

Background: Excellent analgesia and akinesia can be achieved by using peri bulbar anesthesia. It is especially used for cataract surgery worldwide. But sometimes it may lead to serious complications. Comparatively safer method is sub tenon’s anesthesia as there is no use of sharp needles into the orbit. Objective: To study the effectiveness of sub tenon’s anesthesia in comparison to peribulbar anesthesia for small incision cataract surgery and to compare the complications in both the methods. Methods: A hospital based follow up study was carried out among 100 selected patients. They were divided into two groups of 50 each. One group received sub tenon’s anesthesia and the other group received the peribulbar anesthesia. Both the groups were compared for incidence of chemosis, incidence of sub-conjunctival hemorrhage, change in intra ocular pressure, analgesia four hours after post-operatively and akinesia 25 minutes after administration of block. Results: In terms of analgesia, sub-tenon’s anesthesia was better as compared to peribulbar anesthesia. It was also less painful. But the akinesia was incomplete using sub-tenon’s anesthesia. The rate of minor complications like sub-conjunctival hemorrhage, chemosis were more in sub-tenon’s group. In the peribulbar group, a case of retrobulbar hemorrhage was observed. Conclusion: Thus we conclude that sub-tenon’s anesthesia is an effective alternative as well as safer compared to peribulbar anesthesia. It provides adequate akinesia, good analgesia. Sub-tenon’s anesthesia has fewer rate of complications.

Keywords

• anesthesia
• safe method
• analgesia
• cataract surgery
• akinesia