摘要
Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on patients’ needs, surgeons’ preferences and institutional facilities and processes. Although being more invasive than topic anesthesia, and with possible hazardous side effects, peribulbar block is still an effective and successful technique. The utilization of blunt canula and ultrasound guidance might enhance the safety pattern for this technique. Methods: This article presents a revision of 1089 consecutive cases from February 2016 to January 2022, of patients submitted to cataract surgery under peribulbar anesthesia with blunt canula and ultrasound guidance. Results: 1318 surgical records were selected, with 1089 filling the inclusion criteria. There was a higher prevalence of the feminine gender (54%), with a median age of 64.3 (28 - 102) years. Mean IAV was 2.9 mL (sd 0.16 mL, 2.5 - 3.0 mL), with total HOS 91.1%;OR to reach G2 or above for each (ISB/IMB) was 11.0;CA was 47.9%, with mean FAV of 4.29 mL (sd 2.17mL, 2.5 - 15 mL). In 8.9% patients, HOS could not be fully observed. ISB, IMB, CA and FAV were calculated for both groups (non-HOS and HOS-only). OR for CA (non-HOS/HOS-only) was 126.21. The main adverse effects were chemosis (2.9%), hyposphagma (5.7%) and high IOP (7.5%). No procedure was postponed due to anesthesia-associated adverse events. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.
Introduction: Cataract surgery is one of the procedures most performed worldwide. Those are several options for anesthetic management, with many factors that affect the choice of any given technique, depending on patients’ needs, surgeons’ preferences and institutional facilities and processes. Although being more invasive than topic anesthesia, and with possible hazardous side effects, peribulbar block is still an effective and successful technique. The utilization of blunt canula and ultrasound guidance might enhance the safety pattern for this technique. Methods: This article presents a revision of 1089 consecutive cases from February 2016 to January 2022, of patients submitted to cataract surgery under peribulbar anesthesia with blunt canula and ultrasound guidance. Results: 1318 surgical records were selected, with 1089 filling the inclusion criteria. There was a higher prevalence of the feminine gender (54%), with a median age of 64.3 (28 - 102) years. Mean IAV was 2.9 mL (sd 0.16 mL, 2.5 - 3.0 mL), with total HOS 91.1%;OR to reach G2 or above for each (ISB/IMB) was 11.0;CA was 47.9%, with mean FAV of 4.29 mL (sd 2.17mL, 2.5 - 15 mL). In 8.9% patients, HOS could not be fully observed. ISB, IMB, CA and FAV were calculated for both groups (non-HOS and HOS-only). OR for CA (non-HOS/HOS-only) was 126.21. The main adverse effects were chemosis (2.9%), hyposphagma (5.7%) and high IOP (7.5%). No procedure was postponed due to anesthesia-associated adverse events. Discussion: This study points towards the feasibility of the described technique in an outpatient fashion, with low, mild and tolerable side effects associated.
作者
Hugo C. T. Siqueira
Clarissa M. M. Stoffel De Siqueira
Marlon Miguel Bianchi De Lima
Leonardo T. C. Lins
Hugo C. T. Siqueira;Clarissa M. M. Stoffel De Siqueira;Marlon Miguel Bianchi De Lima;Leonardo T. C. Lins(Department of Anesthesiology, Centro de Estudos e Pesquisas Oculistas Associados (CEPOA), Rio de Janeiro, Brazil;Department of Ophthalmology, Centro de Estudos e Pesquisas Oculistas Associados (CEPOA), Rio de Janeiro, Brazil;Department of Oculoplastics, Centro de Estudos e Pesquisas Oculistas Associados (CEPOA), Rio de Janeiro, Brazil)
