[Local parabulbar anesthesia with Greenbaum cannula for most common ophthalmic operations]

To compare two methods of local anesthesia in ophthalmic surgery: classic retrobulbar and new--parabulbar made with Greenbaum cannula and to try to assess new method.

300 patients underwent most common ophthalmic operations: ECCE + PCLI and glaucoma surgery. 150 of them were anesthetised by retrobulbar and 150 by parabulbar (flush) with Greenbaum cannula methods. We compared the presumed influence of these two types of anesthesia on the operations assessing the following: the occurrence "vis a tergo" and posterior capsule rupture. We compared also efficacy of both methods (analgesia and akinesia) and complications (retrobulbar hematoma, globe perforation). We minimalized the volume of anesthetic mixture used in retrobulbar method to 1.5 ml (0.5 ml 0.5% bupivacaine + 1 ml 2% xylocaine).

The number of complications was lower in the group anesthetised by parabulbar method. The complications of local anesthesia were bigger in retrobulbar method (retrobulbar hematoma, globe perforation). Anesthesia in parabulbar method in spite of little volume of anesthetic mixture was very good but akinesia--slightly weaker comparing to retrobulbar injection.

Parabulbar anesthesia made with Greenbaum cannula is a very good, safe method giving very good anesthesia no possibility of globe perforation or retrobulbar hematoma, but the method is for skilled surgeons because of weaker akinesia.