Effects of peribulbar block and incisionless sub-Tenon's block on sleep quality after cataract surgery

Sleep quality often decreases in patients after surgery and may affect postoperative outcomes.

The aim of this study was to compare the effects of peribulbar block and incisionless sub-Tenon's block on postoperative sleep quality.

Patients who underwent cataract surgery under peribulbar block (n = 36) or incisionless sub-Tenon's block (n = 31) were included in the study. The 2 blocks were compared with each other in terms of eyelid and globe movements, corneal sensation, complications, pain, and postoperative sleep quality (evaluated using the Richard-Campbell Sleep Questionnaire (RCSQ) score).

Sixty-seven patients with a mean age of 67 years were included in the study. At the 15th minute after the block (p = 0.066) and at the end of surgery (p = 0.098), akinesia was better in the incisionless sub-Tenon's group, with p-values close to the level of statistical significance. Chemosis was found to be significantly lower in the peribulbar block group than in the incisionless sub-Tenon's block group (p = 0.033) 3 h after surgery. All minor complications, including chemosis, subconjunctival petechiae, and subconjunctival hemorrhage, were observed less frequently in the peribulbar block group, although the differences were not statistically significant (p > 0.05). Pain scores were comparable between the groups (p > 0.05). The total RCSQ score (p = 0.396) and overall sleep perception (p = 0.355) were also comparable between the groups.

The incisionless sub-Tenon's block was superior to the peribulbar block in terms of providing akinesia and reducing the need for maintenance anesthetic medications such as sedatives or analgesics. Although chemosis and subconjunctival hemorrhage occurred more frequently in the incisionless sub-Tenon's group, all events were transient and had no serious clinical significance. The 2 regional techniques were similar in terms of postoperative sleep quality and patient satisfaction.