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Combined retro-peribulbar and subconjunctival anesthesia for evisceration surgery

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Abstract

Purpose

To evaluate the efficacy of retro-peribulbar and subconjunctival anesthesia associated with intravenous sedation in patients undergoing evisceration and orbital implant placement.

Methods

The charts of 217 patients who underwent evisceration with trans-scleral implant placement were reviewed. Midazolam and fentanyl were used for intravenous sedation. For local anesthesia, a combination of lidocaine with epinephrine and bupivacaine was injected into the retrobulbar, upper peribulbar, and subconjunctival areas. The intraoperative pain and need for supplemental anesthetic injection were recorded prospectively.

Results

The surgery was performed with local anesthesia in 116 patients (53%) and with general anesthesia in 101 patients (47%). Patients were significantly older in the local anesthesia group than in the general anesthesia group (mean age, 59.9 years vs 45.2 years; P < .05). Supplemental retrobulbar anesthesia was required in 5 patients (4.3%). Transition to general anesthesia was required in 1 patient (0.9%) due to severe anxiety. Orbital hemorrhage developed after retrobulbar injection in 1 patient (0.9%), but did not preclude performing evisceration.

Conclusions

Combined retro-peribulbar and subconjunctival anesthesia with intravenous sedation can provide safe and effective intraoperative analgesia for evisceration surgery with trans-scleral implant placement.

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Authors and Affiliations

  1. Department of Ophthalmology, Uludag University, Bursa, Turkey

    Bulent Yazici, Ceren Poroy & Ugur Yayla

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  1. Bulent Yazici
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  2. Ceren Poroy
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  3. Ugur Yayla
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Correspondence to Bulent Yazici.

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Authors declare that they have no conflict of interest.

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This study was approved by the Ethics Committee of Uludag University and all patients gave written consent for the use of their anonymous data.

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Yazici, B., Poroy, C. & Yayla, U. Combined retro-peribulbar and subconjunctival anesthesia for evisceration surgery. Int Ophthalmol 40, 1–5 (2020). https://doi.org/10.1007/s10792-019-01144-2

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  • DOI: https://doi.org/10.1007/s10792-019-01144-2

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