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[Titration of intraoperative anesthesia and postoperative analgesia]
W M Budde1, J B Jonas, T M Hemmerling
1Augenklinik mit Poliklinik der Friedrich-Alexander-Universität Erlangen-Nürnberg.
Purpose:
To evaluate a temporary retrobulbar catheter for local anesthesia in intraocular surgery and for postoperative analgesia after intraocular surgery.
Patients And Methods:
The study included 40 patients undergoing pars-plana vitrectomy (n = 24) or cyclocryocoagulation (n = 16). After a retrobulbar injection through a 23 G needle, a commercially available 28 G flexible catheter was inserted through the needle. As soon as the patients complained about pain during or up to 24 hours after surgery, local anesthetics were injected through the catheter.
Results:
Repetitive injections of anesthetics were necessary in 13 patients during pars plana vitrectomy. Starting about 2 hours after surgery, 13 patients after pars-plana vitrectomy and all patients who had undergone cyclocryocoagulation received up to 6 re-injections (every 1.5-5 hours). After all re-injections, the patients became pain-free within two minutes. The catheter was removed after 24 hours.
Conclusions:
The results suggest that a temporary insertion of a catheter into the retrobulbar space allows repetitive application of local anesthetics thus leading to a titrable local anesthesia and postoperative analgesia in intraocular surgery.