Sub-Tenon's anaesthesia: complications and their prevention

Area of Science:

• Ophthalmology
• Anesthesia

Background:

• The sub-Tenon's block, introduced in the 1990s, is a widely adopted anesthesia technique.
• Rapid adoption of new techniques often reveals previously unreported complications.
• The clinical position of the sub-Tenon's block requires re-assessment due to emerging complications.

Purpose of the Study:

• To systematically review reported complications associated with the sub-Tenon's block.
• To discuss management and preventive strategies for identified complications.
• To evaluate the current evidence supporting the safety and efficacy of sub-Tenon's block compared to traditional methods.

Main Methods:

• A systematic literature search was conducted using Medline, EMBASE, and Cochrane databases.
• Keywords included "complications of sub-Tenon's block," "subtenon," "orbital block," and "orbital anesthesia."
• Case reports of complications were identified and analyzed.

Main Results:

• Complications associated with the sub-Tenon's block have been reported in the literature, primarily as case reports.
• The exact incidence of these complications remains unknown.
• Management and preventive measures for these complications are documented.

Conclusions:

• While the sub-Tenon's block is perceived as safer than needle-based blocks, scientific proof is lacking.
• Further prospective, randomized, double-blind controlled trials are essential to definitively establish its superiority.
• Continued vigilance and reporting of complications are necessary for safe clinical practice.