RESEARCH ARTICLE


A Comparative Study Between Single Medial Canthus Injection Using 13 x 0.45 mm Needle and Posterior Sub-Tenon Injection as Local Anesthesia Techniques for Strabismus Surgery in Adults



Norhan A. Sherif1, *, Mayada K. Mohamad1, Ahmed A. Hannon2, Noha A. Osama1
1 Department of Anesthesia, Research Institute of Ophthalmology, Cairo, Egypt
2 Department of Pediatric Ophthalmology and Strabismus, Research Institute of Ophthalmology, Cairo, Egypt


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Creative Commons License
© 2020 Aly Sherif et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Anesthesia, Research Institute of Ophthalmology, Cairo, Egypt; Tel: +201223611054;
Email: anesth.sherif@gmail.com


Abstract

Background:

The quality of ophthalmic anesthesia is an important component of the surgical procedure. There is no absolutely well-tolerated local eye anesthetic technique. However, it is important to choose a technique with high efficacy and safety.

Objective:

This study aimed to compare the efficacy and safety of peribulbar block using medial canthus single injection and posterior sub-tenon injection techniques.

Methods:

This prospective observational study was carried out at the Research Institute of Ophthalmology, Cairo, Egypt during the period from March to December 2018. Consecutive 60 patients of both sexes, aged >18 years-old, scheduled for bilateral strabismus surgery were enrolled in this study. In one eye of the sixty patients, medial canthus single injection peribulbar anesthesia was used (Group A), whereas posterior sub-tenon technique was applied in the other eye (Group B).

Results:

The median total ocular akinesia score was significantly higher in group A than in group B when assessed at 1, 3, and 5 min (p < 0.001). Each of the intraoperative (at 5 min) and postoperative pain scores showed no significant differences between the two groups (p > 0.05). However, the median scores of surgeon and patient satisfaction were significantly higher in group A compared with group B (3 vs. 2 each, p < 0.05). No patient developed occulocardiac reflex or postoperative nausea and vomiting.

Conclusion:

Peribulbar anesthesia by medial canthus single injection showed better akinesia of the globe than sub-tenon injection technique. Otherwise, both techniques were equally effective and safe.

Keywords: Akinesia, Analgesia, Medial canthus, Peribulbar anesthesia, Strabismus, Sub-Tenon.