NIST: Needle Incision Sub-Tenon’s Anesthesia

Abstract

Background: One of the most common regional anesthesia used in cataract surgeries is sub- Tenon’s anaesthesia. Sub-Tenon’s anaesthesia consists of injecting an anaesthetic agent directly into sub-Tenons space with a curved blunted needle. Most common complications related to sub-Tenon’s anaesthesia such as subconjunctival haemorrhage and chemosis has been associated with blunt dissection of conjunctiva and Tenon’s. However, it provides akinesia, analgesia and is considered the choice of anaesthesia in complicated cataracts. Aims and Objectives: An innovative technique of sub- Tenon’s anaethesia, to reduce the existing complications associated with sub-Tenon’s anaesthesia and reducing the volume of anesthetic administered while preserving the quality of anaesthesia. Materials and Methods: An innovative technique was developed avoiding the blunt conjunctival and Tenon’s dissection and replacing it by a point entry that is of size of a needle incision into the sub-Tenon’s space using lacrimal dilator. Results: This novel technique resulted in lesser occurrences of sub conjunctival hemorrhage, chemosis and even in lowering the volume of anesthetic agent used. It gave aesthetic satisfaction to patient postoperatively. Conclusion: NIST technique prevents the complications made by dissection in the conventional technique of sub-Tenon’s anesthesia, while ensuring the quality of anesthesia.

Keywords

• cataract surgery
• innovative technique
• sub-tenon’s anesthesia
• surgical innovation