British Journal of Anaesthesia, 2000, Vol. 85, No. 2 314-316
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia
Brief Communication |
Prospective evaluation of deep topical fornix nerve block versus peribulbar nerve block in patients undergoing cataract surgery using phacoemulsification
1Department of Anaesthesia, Faculty of Medicine, Cairo University, 35A Abou Elfeda Street, Zamalek, Cairo, Egypt and 2Department of Ophthalmology, Research Institute of Ophthalmology, Cairo, Egypt*Corresponding author
Abstract
We compared the efficacy of deep topical fornix nerve block anaesthesia (DTFNBA) versus peribulbar nerve block in patients undergoing cataract surgery using phacoemulsification. We studied 120 patients, allocated randomly to two groups. Group 1 (n=60) received peribulbar block with 5 ml of a 1:1 mixture of 0.5% plain bupivacaine and 2% lidocaine supplemented with hyaluronidase 300 i.u. ml–1. Group 2 received DTFNBA with placement of a sponge soaked with 0.5% bupivacaine deep into the conjunctival fornices for 15 min. No sedation was given to either group. Analgesia was assessed by the reaction to insertion of the superior rectus suture and by questioning during the procedure. A three-point scoring system was used (no pain=0, discomfort=1, pain=2). Scoring was repeated at keratotomy, hydrodissection and hydrodelineation, phacoemulsification, irrigation and aspiration, and at intraocular lens insertion. If the patient’s pain score was 0 or 1, no further action was taken. If the pain score at any stage of the operation was 2, intracameral injection of 1% preservative-free lidocaine was given. One patient in Group 2 needed intracameral lidocaine at the stage of phacoemulsification (P>0.05) and four experienced discomfort at irrigation and aspiration (P=0.043). We conclude that DTFNBA may be a useful needle-free anaesthetic technique in patients undergoing cataract surgery using phacoemulsification.
Br J Anaesth 2000; 85: 314–6
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