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Related Experiment Videos

Sub-Tenon block: a learning curve of 100 cases.

J P Clarke1, G Roberton, J Plummer

  • 1Department of Anaesthesia, Flinders Medical Centre, Bedford Park, South Australia, Australia.

Anaesthesia and Intensive Care
|August 18, 2006
PubMed
Summary

This study assessed the learning curve for sub-Tenon blocks in ophthalmic surgery. After approximately 60 procedures, anaesthetists showed improved block success rates and reduced globe movement.

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Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Surgical Education

Background:

  • Sub-Tenon blocks are an alternative to peribulbar blocks for ophthalmic surgery.
  • Understanding the learning curve is crucial for safe and effective block administration.

Purpose of the Study:

  • To evaluate the learning curve for performing sub-Tenon blocks among anaesthetists experienced in peribulbar techniques.
  • To establish criteria for a successful sub-Tenon block and assess factors influencing its efficacy.

Main Methods:

  • Two anaesthetists performed sub-Tenon blocks for cataract and vitreo-retinal surgeries.
  • Criteria for a good block included chemosis, subconjunctival hemorrhage, globe movement, and need for additional block.
  • Success rates and complication rates were tracked over procedures.

Main Results:

  • Overall success rates were 72% and 56% for the two operators.
  • 10% of cases required an additional peribulbar block.
  • The need for additional blocks and improved globe movement plateaued around 60 procedures.
  • Chemosis and subconjunctival hemorrhage rates did not correlate with increased experience.

Conclusions:

  • Anaesthetists skilled in peribulbar blocks can achieve proficiency in sub-Tenon blocks after approximately 60 procedures.
  • While globe movement and need for supplementary blocks improve with experience, chemosis and hemorrhage rates remain consistent.
  • Sub-Tenon blocks are a viable option for both cataract and vitreo-retinal surgeries.

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