Randomized double-blind clinical trial comparing topical and sub-Tenon's anaesthesia in routine cataract surgery

S. Srinivasan, A. Fernandez de Sevilla, Sivasubramaniam Selvaraj, S. Hasan

    Research output: Contribution to journalArticle

    35 Citations (Scopus)

    Abstract

    Background. Several local anaesthetic techniques are available for cataract surgery. Recently, topical anaesthesia has gained in popularity. A randomized trial was designed to compare patient discomfort and intraoperative complications following routine cataract surgery under topical or sub-Tenon's anaesthesia.

    Methods. A randomized double-blinded placebo-controlled clinical trial of 210 patients assigned to either a sub-Tenon's group (sub-Tenon's anaesthesia with placebo topical balanced salt solution, n=140) or a topical anaesthesia group (topical anaesthesia with placebo sub-Tenon's injection of balanced salt solution, n=70) was carried out. All patients underwent phacoemulsification with intraocular lens implantation. Patients in the sub-Tenon's group received a single injection (3 ml) of a combination of lidocaine 2% (2 ml) and bupivacaine 0.75% (1 ml), and four doses of topical placebo (balanced salt solution). Patients in the topical anaesthesia group received four doses of topical proxymethocaine 0.5% and a placebo sub-Tenon's injection (3 ml) of balanced salt solution. No intracameral injection of local anaesthetic was given. A 10-point visual analogue pain scale was used preoperatively and for postoperative pain assessment immediately after the operation and 30 min postoperatively. The intraoperative complications in the two groups were recorded.

    Results. The mean pain score immediately after surgery was 2.42 (sd 2.2) in the sub-Tenon's group and 3.44 (2.3) in the topical anaesthesia group (P=0.0043). The mean pain score 30 min after surgery was 1.24 (1.7) in the sub-Tenon's group and 2.25 (2.2) in the topical anaesthesia group (P=0.0009).

    Conclusions. Patients undergoing cataract surgery under topical anaesthesia experience more postoperative discomfort than patients receiving sub-Tenon's anaesthesia. Surgery-related complications were similar in both groups.

    Original languageEnglish
    Pages (from-to)683-686
    Number of pages3
    JournalBritish Journal of Anaesthesia
    Volume93
    Issue number5
    DOIs
    Publication statusPublished - 2004

    Keywords

    • anaesthesia, topical
    • anaesthetic techniques
    • regional, sub-Tenon's surgery, cataract
    • LOCAL-ANESTHESIA
    • OCULAR ANESTHESIA
    • EXTRACTION
    • INFILTRATION

    Cite this

    Randomized double-blind clinical trial comparing topical and sub-Tenon's anaesthesia in routine cataract surgery. / Srinivasan, S.; Fernandez de Sevilla, A.; Selvaraj, Sivasubramaniam; Hasan, S.

    In: British Journal of Anaesthesia, Vol. 93, No. 5, 2004, p. 683-686.

    Research output: Contribution to journalArticle

    Srinivasan, S. ; Fernandez de Sevilla, A. ; Selvaraj, Sivasubramaniam ; Hasan, S. / Randomized double-blind clinical trial comparing topical and sub-Tenon's anaesthesia in routine cataract surgery. In: British Journal of Anaesthesia. 2004 ; Vol. 93, No. 5. pp. 683-686.
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    abstract = "Background. Several local anaesthetic techniques are available for cataract surgery. Recently, topical anaesthesia has gained in popularity. A randomized trial was designed to compare patient discomfort and intraoperative complications following routine cataract surgery under topical or sub-Tenon's anaesthesia.Methods. A randomized double-blinded placebo-controlled clinical trial of 210 patients assigned to either a sub-Tenon's group (sub-Tenon's anaesthesia with placebo topical balanced salt solution, n=140) or a topical anaesthesia group (topical anaesthesia with placebo sub-Tenon's injection of balanced salt solution, n=70) was carried out. All patients underwent phacoemulsification with intraocular lens implantation. Patients in the sub-Tenon's group received a single injection (3 ml) of a combination of lidocaine 2{\%} (2 ml) and bupivacaine 0.75{\%} (1 ml), and four doses of topical placebo (balanced salt solution). Patients in the topical anaesthesia group received four doses of topical proxymethocaine 0.5{\%} and a placebo sub-Tenon's injection (3 ml) of balanced salt solution. No intracameral injection of local anaesthetic was given. A 10-point visual analogue pain scale was used preoperatively and for postoperative pain assessment immediately after the operation and 30 min postoperatively. The intraoperative complications in the two groups were recorded.Results. The mean pain score immediately after surgery was 2.42 (sd 2.2) in the sub-Tenon's group and 3.44 (2.3) in the topical anaesthesia group (P=0.0043). The mean pain score 30 min after surgery was 1.24 (1.7) in the sub-Tenon's group and 2.25 (2.2) in the topical anaesthesia group (P=0.0009).Conclusions. Patients undergoing cataract surgery under topical anaesthesia experience more postoperative discomfort than patients receiving sub-Tenon's anaesthesia. Surgery-related complications were similar in both groups.",
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    author = "S. Srinivasan and {Fernandez de Sevilla}, A. and Sivasubramaniam Selvaraj and S. Hasan",
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    TY - JOUR

    T1 - Randomized double-blind clinical trial comparing topical and sub-Tenon's anaesthesia in routine cataract surgery

    AU - Srinivasan, S.

    AU - Fernandez de Sevilla, A.

    AU - Selvaraj, Sivasubramaniam

    AU - Hasan, S.

    PY - 2004

    Y1 - 2004

    N2 - Background. Several local anaesthetic techniques are available for cataract surgery. Recently, topical anaesthesia has gained in popularity. A randomized trial was designed to compare patient discomfort and intraoperative complications following routine cataract surgery under topical or sub-Tenon's anaesthesia.Methods. A randomized double-blinded placebo-controlled clinical trial of 210 patients assigned to either a sub-Tenon's group (sub-Tenon's anaesthesia with placebo topical balanced salt solution, n=140) or a topical anaesthesia group (topical anaesthesia with placebo sub-Tenon's injection of balanced salt solution, n=70) was carried out. All patients underwent phacoemulsification with intraocular lens implantation. Patients in the sub-Tenon's group received a single injection (3 ml) of a combination of lidocaine 2% (2 ml) and bupivacaine 0.75% (1 ml), and four doses of topical placebo (balanced salt solution). Patients in the topical anaesthesia group received four doses of topical proxymethocaine 0.5% and a placebo sub-Tenon's injection (3 ml) of balanced salt solution. No intracameral injection of local anaesthetic was given. A 10-point visual analogue pain scale was used preoperatively and for postoperative pain assessment immediately after the operation and 30 min postoperatively. The intraoperative complications in the two groups were recorded.Results. The mean pain score immediately after surgery was 2.42 (sd 2.2) in the sub-Tenon's group and 3.44 (2.3) in the topical anaesthesia group (P=0.0043). The mean pain score 30 min after surgery was 1.24 (1.7) in the sub-Tenon's group and 2.25 (2.2) in the topical anaesthesia group (P=0.0009).Conclusions. Patients undergoing cataract surgery under topical anaesthesia experience more postoperative discomfort than patients receiving sub-Tenon's anaesthesia. Surgery-related complications were similar in both groups.

    AB - Background. Several local anaesthetic techniques are available for cataract surgery. Recently, topical anaesthesia has gained in popularity. A randomized trial was designed to compare patient discomfort and intraoperative complications following routine cataract surgery under topical or sub-Tenon's anaesthesia.Methods. A randomized double-blinded placebo-controlled clinical trial of 210 patients assigned to either a sub-Tenon's group (sub-Tenon's anaesthesia with placebo topical balanced salt solution, n=140) or a topical anaesthesia group (topical anaesthesia with placebo sub-Tenon's injection of balanced salt solution, n=70) was carried out. All patients underwent phacoemulsification with intraocular lens implantation. Patients in the sub-Tenon's group received a single injection (3 ml) of a combination of lidocaine 2% (2 ml) and bupivacaine 0.75% (1 ml), and four doses of topical placebo (balanced salt solution). Patients in the topical anaesthesia group received four doses of topical proxymethocaine 0.5% and a placebo sub-Tenon's injection (3 ml) of balanced salt solution. No intracameral injection of local anaesthetic was given. A 10-point visual analogue pain scale was used preoperatively and for postoperative pain assessment immediately after the operation and 30 min postoperatively. The intraoperative complications in the two groups were recorded.Results. The mean pain score immediately after surgery was 2.42 (sd 2.2) in the sub-Tenon's group and 3.44 (2.3) in the topical anaesthesia group (P=0.0043). The mean pain score 30 min after surgery was 1.24 (1.7) in the sub-Tenon's group and 2.25 (2.2) in the topical anaesthesia group (P=0.0009).Conclusions. Patients undergoing cataract surgery under topical anaesthesia experience more postoperative discomfort than patients receiving sub-Tenon's anaesthesia. Surgery-related complications were similar in both groups.

    KW - anaesthesia, topical

    KW - anaesthetic techniques

    KW - regional, sub-Tenon's surgery, cataract

    KW - LOCAL-ANESTHESIA

    KW - OCULAR ANESTHESIA

    KW - EXTRACTION

    KW - INFILTRATION

    U2 - 10.1093/bja/aeh254

    DO - 10.1093/bja/aeh254

    M3 - Article

    VL - 93

    SP - 683

    EP - 686

    JO - British Journal of Anaesthesia

    JF - British Journal of Anaesthesia

    SN - 0007-0912

    IS - 5

    ER -