A single-centre study of 1000 consecutive peribulbar blocks.

Area of Science:

• Ophthalmology
• Anesthesiology
• Surgical Anesthesia

Background:

• Peribulbar block is a common technique for ophthalmic anesthesia.
• Assessing the efficacy and safety of this block in a district general hospital setting is crucial for standardizing practice.
• Pain during peribulbar block administration can be a limiting factor.

Purpose of the Study:

• To evaluate the efficacy and safety of peribulbar blocks performed by anesthesiologists in a District General Hospital.
• To determine the impact of a 'painless local' subconjunctival injection on the pain associated with peribulbar block administration.

Main Methods:

• An audit of 1000 consecutive patients receiving peribulbar blocks with 2% lignocaine.
• Efficacy assessment included visual rating scores for operative pain, eye movement, intraocular pressure, and reinjection rates.
• Safety was evaluated by monitoring complications; pain scores were compared using the Mann-Whitney U-test to assess the 'painless local' injection effect.

Main Results:

• Successful akinesia was achieved in 79% of cases with very low operative pain scores (median = 0).
• All recorded complications were minor, with no sight- or life-threatening events.
• The 'painless local' injection (administered to 499 patients) significantly reduced pain scores during block administration (p<0.05).

Conclusions:

• Peribulbar block is a safe and effective anesthesia for eye surgery when performed by experienced staff with methodical training.
• The 'painless local' subconjunctival injection is effective in mitigating the pain associated with peribulbar block administration.
• These findings support the routine use of peribulbar blocks and the 'painless local' technique in ophthalmic anesthesia.