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British Journal of Anaesthesia, 2003, Vol. 91, No. 6 921-923
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Correspondence

Sub-Tenon’s administration of local anaesthetic: a review of the technique

S. J. B. Nicoll1, J. M. I. Hickman Casey1, A. P. J. Lake2, K. Puvanachandra2, C. M. Mather3, J. N. P. Kirkpatrick3, K. Canavan4, A. Dark4 and M. A. Garrioch4

1 Eastbourne, UK 2 Rhyl, UK 3 Cheltenham, UK 4 Glasgow, UK

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Editor—The review article by Canavan and colleagues1 cites inability to lie flat, deafness and mental incapacity as absolute contraindications to sub-Tenon’s anaesthesia. Our department performs 2000 cataract operations per year; we use this technique in 98% of patients.

In individuals who present with severe chronic obstructive pulmonary disease, it is our practice to perform sub-Tenon’s blocks with the patient semi-recumbent. Supplementary oxygen is delivered via a Hudson mask. Profoundly deaf patients are provided with information and instructions written on cards in large, bold type.

Excessive anxiety can be managed using propofol i.v. in small increments (e.g. 10–30 mg). Patients with early dementia can be operated on using sub-Tenon’s anaesthesia if handled sympathetically; speed is of the essence!

Although hyaluronidase promotes spread of local anaesthetic,2 it is not essential for a successful block. In a prospective audit carried out in this hospital in 2001, 71 patients received sub-Tenon’s blocks using a mixture . . . [Full Text of this Article]


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M. Sidery, A. Absalom, R. Burton, K. Canavan, and M. Garrioch
Sub-Tenon's block: are fasting and intravenous access necessary?
Br. J. Anaesth., June 1, 2004; 92(6): 909 - 909.
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