A new local anaesthetic technique in opthalmology - abstract

ABSTRACT

Cataract surgery is the commonest surgical procedure performed by opthalmologists. Most anaesthetic techniques involve the use of needle injections which cause some pain and varying degrees of discomfort. The aim of this study was to determine the efficacy of a new technique of local anaesthetic for cataract surgery in which no needle injections are used. Anaesthesia was achieved in 33 consecutive cataract surgery patients using a new technique which involved topical anaesthesia, using 0.75 percent bupivacaine drops and, for anaesthetising the globe, a subtenon infusion of 1.25 - 1.5 cc of 2 percent xylocaine without adrenaline. Only one patient complained, on the day after surgery, that her operation was painful. The method is faster for the surgeon working alone and allows for maximum use of operating time. The attendance of an anaesthetist has not been found necessary. Three complications were encountered 2 subconjunctival haemorrhages, which did not interfere with surgery; and one mild post-op. ptosis. No pharmacologic agent was used for pre-medication, and the patient's regime of systemic medication and dietary arrangements were unaltered - a desirable situation for the 28 - 30 percent diabetics among our cataract surgery patients. Conclusion: the regime described above provides anaesthesia that is effective, and reduces the risk of complications by avoiding the use of sharp needles. It also saves operating time where the surgeon is working alone. The non-use of sharp needle injections makes the method patient friendly. It is suitable for most adult opthalmic operations, especially in diabetic patients (AU)