Assisted local anaesthesia for cataract surgery (ALACS)

Area of Science:

• Ophthalmology
• Anesthesiology

Background:

• Cataract surgery requires effective anesthesia for patient comfort and surgical success.
• Existing local anesthesia techniques may lack sufficient patient sedation or akinesia.
• General anesthesia offers sedation but carries higher risks for day-stay procedures.

Purpose of the Study:

• To describe and evaluate an Assisted Local Anesthetic technique for Cataract Surgery (ALACS).
• To assess the efficacy and safety of ALACS for extracapsular cataract extraction and intraocular lens implantation.
• To compare the benefits of ALACS with traditional local and general anesthesia.

Main Methods:

• ALACS combines retrobulbar and facial blocks with neurolept-analgesia for enhanced sedation and akinesia.
• The technique was applied to 104 adult patients undergoing cataract and intraocular lens implant surgery.
• Intraoperative blood gas estimations were performed in a subset of patients to assess systemic safety.

Main Results:

• ALACS provided excellent, long-lasting akinesia, analgesia, and adequate ocular proptosis, facilitating surgery.
• Visual results were good, and ocular and anesthetic complications were minimal across 104 cases.
• Intraoperative blood gas analysis indicated the technique is systemically safe.

Conclusions:

• ALACS is a safe and effective assisted local anesthetic technique suitable for most adult cataract and implant surgeries.
• The technique combines the advantages of local anesthesia with the patient quiescence typically seen with general anesthesia.
• ALACS is well-suited for day-stay cataract surgery with a low complication rate.