Résultats de l’anesthésie locorégionale dans la chirurgie vitréo-rétinienne  

Keywords
Locoregional anesthesia, Vitreoretinal surgery, Peribulbar anesthesia, Retro- bulbar anesthesia, Caruncle anesthesia, Sub-tenon’s anesthesia, Pain.

Abstract

Problematic. Locoregional aaesthesia occupies a preponderant place in ophthalmologic surgery. Different techniques are available. Potential complications make it difficult to choose the anesthetic technique.

Aim. To assess results of locoregional anesthesia techniques and patient and surgeon satisfaction in vitreoretinal surgery. Methods This was a prospective study of 80 eyes of 80 patients scheduled for vitreoretinal surgery. The patients were classi- fied into 4 groups of 20 according to the anesthetic technique practiced (peribulbar, retrobulbar, caruncle and sub-Tenon’s). A pre-established questionnaire is completed at the time of the anaesthetic procedure and at the end of the surgery. All pa- tients had undergone an anesthetic technique, pain and satisfaction score assessment.

Results. The mean age of the patients was 59.94 ± 11.64 years with an M/F sex ratio of 1.1. The average duration of the inter- ventions was 72 minutes. The mean akinesia score was 2.92/3, the normotonia score was 1.04/3. Complications were noted in 20% of patients. Perception of pain during injection, intraoperatively and postoperatively was described in 84%, 18% and 82% of patients, respectively. 63% of patients were satisfied with the anaesthetic technique. The average surgeon satisfaction score was 9.8/10. Peribulbar anesthesia had the highest patient satisfaction score. Caruncle anesthesia was associated with the best postoperative analgesia. Sub-Tenon’s anesthesia had the best analgesia upon injection and intraoperatively, the shortest ocular compression duration and the least frequent use of sedation, while retrobulbar anesthesia had the fewest complications.

Conclusion. Sub-Tenon’s anesthesia is the safest and most effective technique in posterior segment surgery.