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Comparing Peribulbar and Topical Anesthesia in Cataract Surgery among Patients with Cardiovascular Disease

Geeta Behera1, Akhilesh Kothari2, Anandaraja Subramanian3

  • 1Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Korean Journal of Ophthalmology : KJO
|January 15, 2024
PubMed

Insights

Topical anesthesia is a safe and effective option for cataract surgery in patients with controlled cardiovascular disease, showing fewer hemodynamic changes and lower pain scores compared to peribulbar anesthesia.

Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Cardiology

Background:

  • Cataract surgery is a common procedure, but anesthetic choices can impact patients with cardiovascular disease.
  • Hemodynamic stability and patient comfort are crucial considerations in this population.

Purpose of the Study:

  • To compare topical anesthesia versus peribulbar anesthesia in cataract surgery.
  • To evaluate hemodynamic changes, complication rates, and pain scores in patients with cardiovascular disease.

Main Methods:

  • A prospective comparative study included 150 patients with controlled cardiovascular disease undergoing cataract surgery.
  • Patients received either topical or peribulbar anesthesia.
  • Hemodynamic parameters, complications, and pain scores (visual analog scale) were recorded at multiple time points.

Main Results:

  • Both anesthesia types were safe, but peribulbar anesthesia showed a significant rise in pulse rate and blood pressure intraoperatively.
  • Systolic blood pressure was significantly higher in the peribulbar group during surgery.
  • The topical anesthesia group reported slightly lower pain scores.

Conclusions:

  • Topical anesthesia is a preferable, non-invasive option for cataract surgery in patients with adequately controlled cardiovascular disease.
  • It offers adequate analgesia with minimal hemodynamic impact.
  • Patients with cardiovascular disease undergoing uncomplicated cataract surgery can be counselled for topical anesthesia.
Abstract

Keywords:
AnesthesiaCardiovascular diseasesCataract extractionPeriocular injectionTopical drug administration

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