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[Vitreoretinal operations with local anesthesia]

A Mutsch1, S Hartwig, A Schenkel

  • 1Augenklinik, Universität Würzburg.

Der Ophthalmologe : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|December 1, 1996
PubMed
Summary
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Retrobulbar anesthesia (RBA) for vitreoretinal surgery effectively manages pain, with patient satisfaction high. Objective stress markers showed minimal changes, indicating RBA

Area of Science:

  • Ophthalmology
  • Anesthesiology
  • Surgical Stress Response

Context:

  • Vitreoretinal surgery often requires effective anesthesia to manage patient discomfort.
  • Assessing both subjective pain scores and objective stress markers is crucial for evaluating anesthetic techniques.

Purpose:

  • To prospectively evaluate intra- and postoperative pain and stress responses in patients undergoing vitreoretinal surgery with retrobulbar anesthesia (RBA).
  • To correlate pain levels with anesthesia quality, surgery duration, and objective stress parameters like plasma cortisol concentration (PCC).

Summary:

  • Mean pain scores were low, peaking at 8 hours postoperatively. Higher quality RBA and shorter surgery duration correlated with less pain.
  • While plasma cortisol concentration (PCC) decreased after premedication, intraoperative and postoperative PCC correlated with pain. Blood pressure and heart rate showed no significant changes.

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  • A high percentage of patients (77.4%) would choose RBA again for future ocular surgery.
  • Impact:

    • This study highlights RBA as a well-tolerated anesthesia method for vitreoretinal procedures, with a high patient satisfaction rate.
    • Understanding the relationship between pain, anesthesia quality, and stress markers can inform anesthetic protocols and improve patient outcomes.
    • Findings support the continued use of RBA in ophthalmic surgery, emphasizing patient comfort and safety.