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      Comparison of the Efficacy and Safety of Contact versus Peribulbar Anaesthesia in Combined Eye Surgery

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          Purpose: To compare the combined levels of comfort, the presence of complications and the results of phacotrabeculectomy surgery obtained with 2 different forms of anaesthesia: topical contact anaesthesia and peribulbar injected anaesthesia. Procedures: In total, 120 consecutive patients undergoing phacotrabeculectomy were randomly assigned to each anaesthesia group. The patients were asked to rate their pain level on a 5-point scale at 3 time points during the procedure. Early and late surgical complications and clinical parameters of success were evaluated. Results: Administration of contact anaesthesia was clearly associated with less pain than injection of peribulbar anaesthesia. The amount of pain or discomfort experienced during or following surgery did not differ between the patient groups. No long-term differences in the tensional results were observed between the groups of the study. Conclusion: The application of contact anaesthesia in the phacotrabeculectomy procedure provides a level of comfort and safety that is comparable to that achieved with peribulbar anaesthesia. Likewise, patients that received contact anaesthesia were as comfortable as patients that received the peribulbar injection of anaesthesia, not only during the immediate postoperative period, but also in terms of their tensional results and their visual acuity in the mid and long term.

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          Most cited references 11

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          Topical anesthesia in phacotrabeculectomy.

          To study the safety and efficacy of topical anesthesia alone, without systemic sedation, in phacotrabeculectomy for cataract and primary open-angle glaucoma.
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            Anesthesia for intraocular surgery.

            Surgeons must decide on the type of anesthesia to use when performing cataract surgery. These "viewpoints" articles provide a well-balanced discussion offering the pros and cons of both topical anesthesia and retrobulbar/peribulbar injection. Dr. Dutton gives an overview of both techniques, focusing on relevant orbital anatomy. Drs. Hassan, Edelhauser and Kim, review the various types of topical anesthesia currently in use, and Drs. Spriggs and Broocker examine retrobulbar and peribulbar injections. Both techniques are associated with advantages and risks, so each surgeon must decide which technique is best suited for his or her own practice.
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              Provision of anesthesia with single application of lidocaine 2% gel


                Author and article information

                S. Karger AG
                January 2009
                20 November 2008
                : 223
                : 1
                : 60-67
                Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain
                173713 Ophthalmologica 2009;223:60–67
                © 2008 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 3, Tables: 7, References: 17, Pages: 8
                Original Paper


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