Abstract
Although phacoemulsification with only topical anaesthesia is possible, the level of any discomfort perceived by the patient is unknown. Topical anaesthesia eliminates any risk of inadvertent ocular or orbital injury. Twenty-four patients undergoing phacoemulsification under only topical anaesthesia (g. amethocaine 1%) were compared with 23 patients undergoing the same procedure with peribulbar anaesthesia (5 ml lignocaine 2%, 5 ml bupivacaine 0.5% and 75 units hyaluronidase). Perceived pain on administration of the anaesthesia, per-operatively and post-operatively was assessed by a nursing officer using a visual analogue scale (0-10). It was found that there was no difference in pain score between the two groups on induction of anaesthesia. Per-operatively and post-operatively scores were higher in the topical group than in the peribulbar group (p<0.05, Mann-Whitney U-test), though most of these were within the range 0-3, (‘no pain’ to ‘slight pain’). There was no difference in the amount of analgesia dispensed to the two groups on the ward post-operatively. In conclusion, topical anaesthesia provides adequate anaesthesia for phacoemulsification. Although a small increase in the level of discomfort was observed, the pain levels reported were small and may not be clinically significant when set against the reduced incidence of anaesthetic-related complications.
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References
Grabow HB . Topical anaesthesia for cataract surgery. Eur J Implant Refract Surg 1993;5:20–4.
Hamilton RC, Gimbel HV, Javitt JC . The prevention of complications of regional anaesthesia for ophthalmology. In Zahl K, Keltzer MA (eds). Ophthalmology clinics of North America, vol 3. Regional anaesthesia for intraocular surgery. Philadelphia: WB Saunders, 1990:111–25.
Knapp H . On cocaine and its use in ophthalmic surgery. Arch Ophthalmol 1884;13:402–48.
Wylie J, Henderson M, Doyle M, Hickey-Dwyer M . Persistent binocular diplopia following cataract surgery: aetiology and management. Eye 1994;8:543–6.
Murdoch IE . Peribulbar versus retrobulbar anaesthesia. Eye 1990;4:445–9.
Davis DB, Mandel MR . Efficacy and complication rate of 16 224 consecutive peribulbar blocks. J Cataract Refract Surg 1994;20:327–37.
Hamilton RC . Brain stem anaesthesia following retrobulbar blockade. Anaesthesiology 1985;63:688–90.
Berry CB, Murphy PM . Regional anaesthesia for cataract surgery. Br J Hosp Med 1993;49:680–701.
Stevens JD . A new local anaesthesia technique for cataract extraction by one quadrant sub-Tenon's infiltration. Br J Ophthalmol 1992;76:670–4.
Sanders R, MacEwen CJ, Haining WM . A comparison of prophylactic, topical and subconjunctival treatment in cataract surgery. Eye 1992;6:105–10.
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Duguid, I., Claoué, C., Thamby-Rajah, Y. et al. Topical anaesthesia for phacoemulsification surgery. Eye 9, 456–459 (1995). https://doi.org/10.1038/eye.1995.106
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DOI: https://doi.org/10.1038/eye.1995.106
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Eye (1996)