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      Comparison of Olive Tipped and Conventional Steven's Cannula for Sub-Tenon Ophthalmic Anesthesia

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          Abstract

          PURPOSE:

          To compare the efficacy of the olive tipped (OT) cannula to the conventional Steven's cannula for sub-Tenon block (STB) before cataract surgery.

          METHODS:

          This prospective, randomized, double-masked compared STB delivered in cataract surgery patients with an OT cannula or a conventional Steven's cannula (ST). Outcome variables included the akinesia score and lid movement scores at 5 and 10 min. The patient perception of pain during delivery of the STB and surgery were also compared between groups. Surgeon satisfaction with anesthesia was compared between groups. P <0.05 was statistically significant.

          RESULTS:

          There were sixty patients in each group. The age between groups was not statistically different ( P = 0.4). The body mass index was higher in the ST group compared to the OT group ( P < 0.001). The akinesia score at 5 and 10 min did not differ between groups ( P = 0.07 and P = 0.6, respectively). The patient perception of pain during STB and surgery were similar between groups ( P = 0.1 and P = 0.06, respectively). There were six patients with mild chemosis and redness in the OT group and 15 patients in the ST group.

          CONCLUSION:

          An OT cannula is equally effective as the conventional Steven's cannula for delivering STB anesthesia before cataract surgery.

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          Most cited references17

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          Sub-Tenon's anaesthesia: complications and their prevention.

          The advent of a new technique that is considered much safer than previously established one leads to its rapid adoption. This usually leads to the identification of previously unreported complications of the new technique, and a re-assessment of its position in clinical care, which is precisely the state of play with the sub-Tenon's block. The sub-Tenon's block was introduced into the clinical practice in early 1990. A systematic recent search of subject headings such as complications of sub-Tenon's block, subtenon, orbital block, orbital block complications, and orbital anaesthesia was performed in Medline, EMBASE, and Cochrane database. Indeed there are complications of sub-Tenon's block published as case reports and the exact incidence of these complications is not known. Management and preventive measures of these complications are described. Although the sub-Tenon's block appears to be relatively safer than needle-based blocks but a proper prospective, randomized, double-blind controlled trial is essential for scientific proof that sub-Tenon's block is better than needle-based blocks.
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            Globe perforation associated with subtenon's anesthesia.

            To report a case of globe perforation while initiating posterior subtenon's anesthesia. Case report. A 40-year-old man with a history of retinal detachment in both eyes presented for repair of a second retinal detachment in the LE. Upon dissecting a space beneath the Tenon capsule with scissors, the globe was perforated. In patients with prior ophthalmologic surgery, thinned sclera, or excess scar tissue, increased caution should be employed during initiation of sub-Tenon anesthesia or an alternative method should be used.
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              Complications of Ophthalmic Regional Blocks: Their Treatment and Prevention

              Complications following ophthalmic regional anaesthesia are rare but are reported during both needle (intraconal and extraconal blocks) and blunt cannula (sub-Tenon’s block) techniques. At present there is no perfect technique of ophthalmic regional anaesthesia. This article reports on the complications, treatment and prevention of commonly used ophthalmic regional blocks. Thorough knowledge of the measures required to deal with complications when they occur are of paramount importance for safe clinical practice.
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                Author and article information

                Journal
                Middle East Afr J Ophthalmol
                Middle East Afr J Ophthalmol
                MEAJO
                Middle East African Journal of Ophthalmology
                Medknow Publications & Media Pvt Ltd (India )
                0974-9233
                0975-1599
                Oct-Dec 2016
                : 23
                : 4
                : 307-310
                Affiliations
                [1] Department of Outreach and Eligibility, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
                [1 ] Department of Anesthesia, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
                [2 ] Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
                Author notes
                [*]

                These authors equally contributed to this work

                Address for correspondence: Dr. Abdul Zahoor, Department of Anesthesia, King Khaled Eye Specialist Hospital, POB 7191, Aruba Road, Riyadh, 11462 Kingdom of Saudi Arabia. E-mail: azahoor@ 123456kkesh.med.sa
                Article
                MEAJO-23-307
                10.4103/0974-9233.194080
                5141624
                753c0123-ccd9-4454-89b3-f68c5309aab3
                Copyright: © Middle East African Journal of Ophthalmology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Original Article

                Ophthalmology & Optometry
                anesthesia,cannula,ophthalmic anesthesia,sub-tenon's block
                Ophthalmology & Optometry
                anesthesia, cannula, ophthalmic anesthesia, sub-tenon's block

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