Pain during pars plana vitrectomy following sub-Tenon versus peribulbar anesthesia: A randomized trial
To compare pain during pars plana vitrectomy (PPV) following topical lidocaine jelly and sub-Tenon anesthesia versus peribulbar anesthesia. Fifty-four patients were enrolled in the study (26 in Group ST and 28 in Group PB). Baseline characteristics, including age, gender, and presence of comorbiditi...
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| description | To compare pain during pars plana vitrectomy (PPV) following topical lidocaine jelly and sub-Tenon anesthesia versus peribulbar anesthesia. Fifty-four patients were enrolled in the study (26 in Group ST and 28 in Group PB). Baseline characteristics, including age, gender, and presence of comorbidities, were similar in both groups. The surgery performed was PPV alone in 10 and 14 patients in the ST and PB groups, respectively, and combined phacoemulsification and PPV in 16 and 14 patients in the ST and PB groups, respectively (p = 0.39, Pearson). Surgery duration (mean ± SD minutes) was similar in the two groups (62 ± 12 for ST and 70 ± 20 for PB, p = 0.09, t-Test). No patients needed supplemental topical or intravenous anesthesia during surgery. No sight- or life-threatening complication was observed in either group. VAS score was significantly lower in the ST compared to the PB group (median (interquartile range) was 1 (2.25-0) in the ST group compared to 11.5 (29.75-5) in the PB group, p< 0.0001, Wilcoxon). In this study of patients who underwent PPV for MH or ERM, topical followed by sub-Tenon anesthesia was more effective in controlling pain during the whole vitrectomy procedure than peribulbar anesthesia. Compared to peribulbar anesthesia which is administered with a sharp needle, sub-Tenon anesthesia administered with a blunt cannula may be associated with a reduced risk of such adverse events as globe perforation, retrobulbar hemorrhage, and inadvertent injection of anesthesia into the optic nerve sheath. |
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Fifty-four patients were enrolled in the study (26 in Group ST and 28 in Group PB). Baseline characteristics, including age, gender, and presence of comorbidities, were similar in both groups. The surgery performed was PPV alone in 10 and 14 patients in the ST and PB groups, respectively, and combined phacoemulsification and PPV in 16 and 14 patients in the ST and PB groups, respectively (p = 0.39, Pearson). Surgery duration (mean ± SD minutes) was similar in the two groups (62 ± 12 for ST and 70 ± 20 for PB, p = 0.09, t-Test). No patients needed supplemental topical or intravenous anesthesia during surgery. No sight- or life-threatening complication was observed in either group. VAS score was significantly lower in the ST compared to the PB group (median (interquartile range) was 1 (2.25-0) in the ST group compared to 11.5 (29.75-5) in the PB group, p< 0.0001, Wilcoxon). In this study of patients who underwent PPV for MH or ERM, topical followed by sub-Tenon anesthesia was more effective in controlling pain during the whole vitrectomy procedure than peribulbar anesthesia. Compared to peribulbar anesthesia which is administered with a sharp needle, sub-Tenon anesthesia administered with a blunt cannula may be associated with a reduced risk of such adverse events as globe perforation, retrobulbar hemorrhage, and inadvertent injection of anesthesia into the optic nerve sheath.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0236624</identifier><identifier>PMID: 32760093</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Anesthesia ; Biology and Life Sciences ; Cataracts ; Cocaine ; Comparative analysis ; Complications and side effects ; Demographics ; Demography ; Diabetes ; Diabetic retinopathy ; Drug therapy ; Eye surgery ; General anesthesia ; Health sciences ; Hemorrhage ; Hypertension ; Informed consent ; Intravenous administration ; Lidocaine ; Local anesthesia ; Medical materials ; Medical schools ; Medicine and Health Sciences ; Ophthalmology ; Optic nerve ; Pain ; Patient outcomes ; Patients ; Perforation ; Postoperative pain ; Randomization ; Retina ; Ribeiro, Daniel ; Risk management ; Risk reduction ; Ropivacaine ; Sheaths ; Studies ; Surgery ; Tubes ; Vitrectomy</subject><ispartof>PloS one, 2020-08, Vol.15 (8), p.e0236624-e0236624</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Ribeiro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Fifty-four patients were enrolled in the study (26 in Group ST and 28 in Group PB). Baseline characteristics, including age, gender, and presence of comorbidities, were similar in both groups. The surgery performed was PPV alone in 10 and 14 patients in the ST and PB groups, respectively, and combined phacoemulsification and PPV in 16 and 14 patients in the ST and PB groups, respectively (p = 0.39, Pearson). Surgery duration (mean ± SD minutes) was similar in the two groups (62 ± 12 for ST and 70 ± 20 for PB, p = 0.09, t-Test). No patients needed supplemental topical or intravenous anesthesia during surgery. No sight- or life-threatening complication was observed in either group. VAS score was significantly lower in the ST compared to the PB group (median (interquartile range) was 1 (2.25-0) in the ST group compared to 11.5 (29.75-5) in the PB group, p< 0.0001, Wilcoxon). In this study of patients who underwent PPV for MH or ERM, topical followed by sub-Tenon anesthesia was more effective in controlling pain during the whole vitrectomy procedure than peribulbar anesthesia. Compared to peribulbar anesthesia which is administered with a sharp needle, sub-Tenon anesthesia administered with a blunt cannula may be associated with a reduced risk of such adverse events as globe perforation, retrobulbar hemorrhage, and inadvertent injection of anesthesia into the optic nerve sheath.</description><subject>Anesthesia</subject><subject>Biology and Life Sciences</subject><subject>Cataracts</subject><subject>Cocaine</subject><subject>Comparative analysis</subject><subject>Complications and side effects</subject><subject>Demographics</subject><subject>Demography</subject><subject>Diabetes</subject><subject>Diabetic retinopathy</subject><subject>Drug therapy</subject><subject>Eye surgery</subject><subject>General anesthesia</subject><subject>Health sciences</subject><subject>Hemorrhage</subject><subject>Hypertension</subject><subject>Informed consent</subject><subject>Intravenous administration</subject><subject>Lidocaine</subject><subject>Local 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during pars plana vitrectomy following sub-Tenon versus peribulbar anesthesia: A randomized trial</title><author>Ribeiro, Jefferson A.S ; Ribeiro, Daniel S ; Scott, Ingrid U ; Abrao, Joao ; Jorge, Rodrigo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-5bea012f5b7ba1287d59d8e5de129e9c768709543e62174d3e843114fd9d8f0e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anesthesia</topic><topic>Biology and Life Sciences</topic><topic>Cataracts</topic><topic>Cocaine</topic><topic>Comparative analysis</topic><topic>Complications and side effects</topic><topic>Demographics</topic><topic>Demography</topic><topic>Diabetes</topic><topic>Diabetic retinopathy</topic><topic>Drug therapy</topic><topic>Eye surgery</topic><topic>General anesthesia</topic><topic>Health sciences</topic><topic>Hemorrhage</topic><topic>Hypertension</topic><topic>Informed 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one</jtitle><date>2020-08-06</date><risdate>2020</risdate><volume>15</volume><issue>8</issue><spage>e0236624</spage><epage>e0236624</epage><pages>e0236624-e0236624</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To compare pain during pars plana vitrectomy (PPV) following topical lidocaine jelly and sub-Tenon anesthesia versus peribulbar anesthesia. Fifty-four patients were enrolled in the study (26 in Group ST and 28 in Group PB). Baseline characteristics, including age, gender, and presence of comorbidities, were similar in both groups. The surgery performed was PPV alone in 10 and 14 patients in the ST and PB groups, respectively, and combined phacoemulsification and PPV in 16 and 14 patients in the ST and PB groups, respectively (p = 0.39, Pearson). Surgery duration (mean ± SD minutes) was similar in the two groups (62 ± 12 for ST and 70 ± 20 for PB, p = 0.09, t-Test). No patients needed supplemental topical or intravenous anesthesia during surgery. No sight- or life-threatening complication was observed in either group. VAS score was significantly lower in the ST compared to the PB group (median (interquartile range) was 1 (2.25-0) in the ST group compared to 11.5 (29.75-5) in the PB group, p< 0.0001, Wilcoxon). In this study of patients who underwent PPV for MH or ERM, topical followed by sub-Tenon anesthesia was more effective in controlling pain during the whole vitrectomy procedure than peribulbar anesthesia. Compared to peribulbar anesthesia which is administered with a sharp needle, sub-Tenon anesthesia administered with a blunt cannula may be associated with a reduced risk of such adverse events as globe perforation, retrobulbar hemorrhage, and inadvertent injection of anesthesia into the optic nerve sheath.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32760093</pmid><doi>10.1371/journal.pone.0236624</doi><tpages>e0236624</tpages><orcidid>https://orcid.org/0000-0001-5995-9193</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Anesthesia Biology and Life Sciences Cataracts Cocaine Comparative analysis Complications and side effects Demographics Demography Diabetes Diabetic retinopathy Drug therapy Eye surgery General anesthesia Health sciences Hemorrhage Hypertension Informed consent Intravenous administration Lidocaine Local anesthesia Medical materials Medical schools Medicine and Health Sciences Ophthalmology Optic nerve Pain Patient outcomes Patients Perforation Postoperative pain Randomization Retina Ribeiro, Daniel Risk management Risk reduction Ropivacaine Sheaths Studies Surgery Tubes Vitrectomy |
| title | Pain during pars plana vitrectomy following sub-Tenon versus peribulbar anesthesia: A randomized trial |
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