Anesthesia in retinal surgery: A national survey

Area of Science:

• Ophthalmology
• Anesthesiology
• Surgical Practice

Background:

• Local-regional anesthesia (LRA) techniques like peribulbar anesthesia (PBA) and sub-Tenon's anesthesia (STA) are increasingly used for vitreoretinal surgery.
• Current recommendations for LRA indications and contraindications are lacking, and French practices remain unevaluated.

Purpose of the Study:

• To describe current French anesthesia practices for vitreoretinal surgery.
• To identify the needs of French professionals regarding LRA techniques.

Main Methods:

• A 23-question survey was distributed to French-speaking retinal surgeons via the Club Francophone des Spécialistes de la Rétine (CFSR).
• The questionnaire focused on anesthesia type based on surgical indication, LRA methods, and surgeon needs.

Main Results:

• 114 surgeons completed the survey, revealing heterogeneous practices in LRA techniques and contraindications.
• Peribulbar anesthesia (PBA) was preferred over sub-Tenon's anesthesia (STA); private-sector and experienced surgeons used PBA more frequently.
• General anesthesia was common for scleral buckling, while PBA was favored for vitrectomy. Hypnosis was rarely used.

Conclusions:

• Significant variability exists in French vitreoretinal surgery anesthesia practices.
• There is a clear need for guidelines and further research, including comparative studies of PBA and STA, and investigations into myopia as a contraindication.
• Further studies should also explore ultrasound guidance and the role of hypnosis in LRA for vitreoretinal surgery.