SUB-CONJUNCTIVAL ANAESTHESIA IN TRABECULECTOMY AN EXPERIENCE WITH 80 CASES

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Nasir Saeed
Namika Nasir
Muhammad Daud Khan

Abstract

Objective: To determine the patients tolerability, comfort, ease of application and surgeons convenience

with sub-conjunctival anaesthesia for trabeculectomy in our clinical setup.

Material and Methods: It was a prospective and observational study conducted at the department of

Ophthalmology, Postgraduate Medical Institute, Hayatabad Medical Complex and Khyber Teaching

Hospital, Peshawar. All patients were injected with up to 1 ml of a 1:1mixture of 2% lignocain with

epinephrine and 0.75% bupivacaine sub-conjunctivally and operated for trabeculectomy. Intra-operative

pain, presence of eye movements and complications of anaesthesia were monitored. Bleb leak and ptosis

were assessed postoperatively. Patient discomfort was assessed intraoperatively and 24 hours

postoperatively using a standardized verbal descriptive chart with 0 to 4 pain scoring levels.

Results: Eighty patients underwent sub-conjunctival anaesthesia for trabeculectomy. Sixty-eight (85%)

patients remained comfortable throughout the procedure. Only 3 (3.75%) patients required supplemental

subconjunctival anaesthesia block during surgery, while 7 (8.75%) patients required a facial block. Two

(2.5%) patients needed retrobulbar block. No surgery was postponed and none of the patient required

general anesthesia. Most common complication noted was chemosis of the conjunctiva (70%). In two cases

(2.5%) it interfered with the surgery and the surgery time was prolonged. Small sub-conjunctival

hemorrhage developed in 43 (53.75%) patients; however, this did not interfere with the surgery. No case of

postoperative bleb leak and ptosis was noted.

Conclusion: The technique of subconjunctival anaesthesia is safe, effective, tolerable, and convenient. It

is not associated with any remarkable postoperative complications because it is performed under direct

visualization.

Article Details

How to Cite
1.
Saeed N, Nasir N, Khan MD. SUB-CONJUNCTIVAL ANAESTHESIA IN TRABECULECTOMY AN EXPERIENCE WITH 80 CASES. J Postgrad Med Inst [Internet]. 2011 Jul. 25 [cited 2022 Oct. 7];19(2). Available from: https://jpmi.org.pk/index.php/jpmi/article/view/28
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Original Article

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