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International Ophthalmology
Published in: International Ophthalmology 1/2020

01-01-2020 | Local Anesthesia in Dentistry | Original Paper

Combined retro-peribulbar and subconjunctival anesthesia for evisceration surgery

Authors: Bulent Yazici, Ceren Poroy, Ugur Yayla

Published in: International Ophthalmology | Issue 1/2020

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Abstract

Purpose

To evaluate the efficacy of retro-peribulbar and subconjunctival anesthesia associated with intravenous sedation in patients undergoing evisceration and orbital implant placement.

Methods

The charts of 217 patients who underwent evisceration with trans-scleral implant placement were reviewed. Midazolam and fentanyl were used for intravenous sedation. For local anesthesia, a combination of lidocaine with epinephrine and bupivacaine was injected into the retrobulbar, upper peribulbar, and subconjunctival areas. The intraoperative pain and need for supplemental anesthetic injection were recorded prospectively.

Results

The surgery was performed with local anesthesia in 116 patients (53%) and with general anesthesia in 101 patients (47%). Patients were significantly older in the local anesthesia group than in the general anesthesia group (mean age, 59.9 years vs 45.2 years; P < .05). Supplemental retrobulbar anesthesia was required in 5 patients (4.3%). Transition to general anesthesia was required in 1 patient (0.9%) due to severe anxiety. Orbital hemorrhage developed after retrobulbar injection in 1 patient (0.9%), but did not preclude performing evisceration.

Conclusions

Combined retro-peribulbar and subconjunctival anesthesia with intravenous sedation can provide safe and effective intraoperative analgesia for evisceration surgery with trans-scleral implant placement.
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Metadata
Title
Combined retro-peribulbar and subconjunctival anesthesia for evisceration surgery
Authors
Bulent Yazici
Ceren Poroy
Ugur Yayla
Publication date
01-01-2020
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 1/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01144-2

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