Continuous retrobulbar anesthesia for scierai buckling surgery using an ultra-fine spinal anesthesia catheter

PurposeTo evaluate a novel retrobulbar catheter technique for intraoperative and postoperative analgesia in patients undergoing scierai buckling procedures.MethodsThis prospective noncomparative clinical interventional case-series study included 43 consecutive patients undergoing scierai buckling pr...

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Bibliographic Details
Published in:Canadian journal of anesthesia 2002-05, Vol.49 (5), p.487-489
Main Authors: Jonas, Jost B., Jäger, Melanie, Hemmerling, Thomas M.
Format: Article
Language:English
Subjects:
Anesthesia
Pain
Postoperative period
Surgery
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Summary:PurposeTo evaluate a novel retrobulbar catheter technique for intraoperative and postoperative analgesia in patients undergoing scierai buckling procedures.MethodsThis prospective noncomparative clinical interventional case-series study included 43 consecutive patients undergoing scierai buckling procedures as treatment of rhegmatogenous retinal detachments. Using a commercially available retrobulbar needle with a diameter of 0.80 mm and a length of 38 mm, 7 mL of local anesthetic were injected into the retrobulbar space. Through the same needle, a 28-gauge commercially available flexible spinal anesthesia catheter was introduced into the retrobulbar space, the needle was withdrawn, and the catheter was fixed. The catheter was removed on the morning of the first postoperative day. When the patients started to feel pain during or after surgery, 2 mL of local anesthetic were re-injected through the catheter.ResultsDuring surgery, 12 (27.9%) patients received a pain-free re-injection through the retrobulbar catheter resulting in a marked reduction of pain. Two (4.7%) patients needed a second re-injection. In the postoperative period, 23 (53.5%) patients experienced pain of grade 3 or higher 5.4 ± 6.7 hr after start of surgery and received a retrobulbar re-injection. Eleven (25.6%) patients asked for a second postoperative re-injection, and four (9.3%) patients received a third postoperative re-injection. Cardiopulmonary and central nervous adverse effects were not noticed.ConclusionsUse of an ultra-fine retrobulbar catheter for repeat intraoperative and postoperative injections of local anesthetics is a simple and effective method to achieve analgesia during and after scierai buckling procedures.
ISSN:0832-610X
1496-8975
DOI:10.1007/BF03017926