Sub-Tenon versus peribulbar anesthesia in vitreoretinal surgery: A retrospective analysis in a tertiary eye care center

Abstract

AIM: The aim of this study was to compare the efficacy of sub-Tenon and peribulbar anesthesia in vitreoretinal surgeries. Methods: This was a retrospective study where patients who received peribulbar or sub-Tenon anesthesia during vitreoretinal surgeries between July 2023 and September 2023 were included. Lid movements, subconjunctival hemorrhage, chemosis, and akinesia were evaluated after anesthesia was injected in the two groups. Pain score was evaluated at the time of anesthesia, intraoperatively, and postoperatively after 1 h. Results: We included 108 patients, of which 58 were given peribulbar and 50 had sub-Tenon anesthesia and had mean ± standard deviation age of 56.8 ± 12.6 years and 57.90 ± 13.0 years, respectively (P = 0.67). Baseline, intraoperative, and postoperative (at 1 h after surgery) systolic blood pressure (BP), diastolic BP, and pulse rate were similar in both groups. None of the patients had any systemic complications in both the peribulbar and sub-Tenon groups. The mean pain score at postoperative 1 h was similar in both groups (P = 0.58). At postoperative 1 day, two patients had ecchymosis in the peribulbar group. Eighteen cases had lid edema in the peribulbar group compared to no lid edema in the sub-Tenon group (P < 0.001). Conclusion: Sub-Tenon anesthesia is a simple, safe, and less traumatic technique that is as good as peribulbar in terms of providing analgesia. Although sub-Tenon could not produce total akinesia in most of the cases, the surgeon was able to operate comfortably with negligible chance of anesthesia-related complications. However, the anesthetist also plays an important role in a multidisciplinary approach in the management of vitreoretinal surgeries.

Keywords

• akinesia
• analgesia
• peribulbar anesthesia
• sub-tenon anesthesia
• vitreoretinal surgery