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Sub-Tenon's block with an ultrashort cannula.
Bartley J McNeela1, Chandra M Kumar
1Department of Ophthalmology, North Riding Infirmary, Middlesbrough, United Kingdom. mcneela@jerseymail.co.uk
Journal of Cataract and Refractive Surgery
|April 20, 2004
Summary
A new blunt cannula technique for sub-Tenon
Area of Science:
- Ophthalmology
- Anesthesia
- Surgical Techniques
Background:
- Sub-Tenon's block is a common method for ocular anesthesia.
- Traditional needles carry risks of globe perforation and muscle damage.
Purpose of the Study:
- To assess the efficacy and safety of an orbital block using a novel ultrashort, wide-bore blunt metal cannula.
- To evaluate local anesthetic delivery into the anterior sub-Tenon's space.
Main Methods:
- Fifty-nine patients undergoing phacoemulsification received a sub-Tenon's block with lidocaine, adrenaline, and hyaluronidase via a blunt cannula.
- Ocular and lid movements, incyclotorsion, and pain were assessed post-injection.
- B-scan ultrasonography was used in a subset of patients to visualize fluid spread.
Main Results:
- Excellent akinesia was achieved in 98.30% of patients within 4 minutes.
- Minimal pain on injection was reported by most patients (67.79% reported no pain).
- Minor chemosis and conjunctival hemorrhage occurred in a significant proportion of patients.
Conclusions:
- The blunt, ultrashort cannula facilitates effective and predictable ocular anesthesia via sub-Tenon's block.
- This technique significantly lowers the risk of globe perforation and other severe complications.