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    Efficacy of sub-Tenon's block using an equal volume of local anaesthetic administered either as a single or as divided doses. A randomised clinical trial.

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    Authors
    Khan, Ehtesham I
    Mustafa, Jawad
    McAdoo, John
    Shorten, George
    Affiliation
    Dept of Anaesthesia, Cork University Hospital and University College Cork, Ireland, Wilton, Cork, Co Cork, Ireland. eikhan@yahoo.co.uk.
    Issue Date
    2009
    
    Metadata
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    Citation
    Efficacy of sub-Tenon's block using an equal volume of local anaesthetic administered either as a single or as divided doses. A randomised clinical trial. 2009, 9:2 BMC Anesthesiol
    Journal
    BMC anesthesiology
    URI
    http://hdl.handle.net/10147/201215
    DOI
    10.1186/1471-2253-9-2
    PubMed ID
    19323806
    Additional Links
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2666666/pdf/1471-2253-9-2.pdf
    http://www.biomedcentral.com/content/pdf/1471-2253-9-2.pdf
    Abstract
    Sub-Tenon's anaesthetic is effective and reliable in producing both akinesia and anaesthesia for cataract surgery. Our clinical experience indicates that it is sometimes necessary when absolute akinesia is required during surgery to augment the block with 1-2 ml of local anaesthetic. Hypothesis was that after first injection some of the volume injected may spill out and before second injection the effect of hyaluronidase has taken place and second volume injectate will have desired effect.
    A prospective, randomised, control trial in which patients were randomly allocated to one of two groups. In group 1, single injection of 5 ml of local anaesthetic was injected. In group 2, 3 ml of the same anaesthetic solution was injected followed by application of gentle orbital pressure for 2 minutes. A further 2 ml of the same anaesthetic solution was injected through the same conjunctival incision. Measurement of movement in four quadrants of eye was done by the surgeon at 3 and 6 minutes. Intraocular pressure, chemosis, and subconjuctival haemorrhage were also measured.
    Significant differences at 3 minutes between groups for overall movement, medial, superior, and lateral quadrants occurred. At 6 minutes no significant group differences emerged for the overall movement or for any of four quadrants.
    Single injection of local anaesthesia for sub-Tenon's block with mixture of lignocaine with adrenaline, bupivacaine and hyaluronidase was found to be superior to provide akinesia of ocular muscles compared to divided dose given by two injections. No difference in groups in terms of haemorrhage, chemosis, patient's satisfaction and intraocular pressure was found.
    Trial registration no-ISRCTN73431052.
    Item Type
    Article
    Language
    en
    ISSN
    1471-2253
    ae974a485f413a2113503eed53cd6c53
    10.1186/1471-2253-9-2
    Scopus Count
    Collections
    Cork University Hospital

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