Abstract
Purpose To study the distribution of anaesthetic fluid during sub-Tenon's block by B-scan ultrasonography using cannulae of three different lengths.
Methods A total of 30 patients undergoing routine phacoemulsification and lens implantation were studied after informed consent had been obtained. Ages ranged from 60 to 92 years and globe axial lengths from 21.50 to 27.00 mm. All were given a sub-Tenon's block and the patients were classified into three groups in which either a long, intermediate, or short cannula was used. B-scan ultrasonography was performed before administration of the anaesthetic agent, during injection, and 2 min after completion of the injection.
Results In all patients the optic nerve was identified. During the injection, anaesthetic fluid could be seen tracking behind the globe and opening up the posterior sub-Tenon's space (the previously described ‘T’-sign). After 2 min very little or no fluid was seen, suggesting that it had dispersed into the surrounding tissues. There was no discernible difference in the distribution of fluid or in the quality of the block in the three groups.
Conclusions B-scan ultrasonography can reliably identify the distribution of anaesthetic fluid during sub-Tenon's block. Anaesthetic agents can be successfully delivered into the sub-Tenon's space by long, intermediate, or short cannulae.
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References
Stevens JD . A new local anaesthesia technique for cataract extraction by one quadrant sub-Tenon's infiltration. Br J Ophthalmol 1992; 76: 670–674.
Kumar CM, Dodds C . A disposable plastic sub-Tenon cannula. Anaesthesia 2001; 56: 399–400.
Greenbaum S . Parabulbar anaesthesia. Am J Ophthalmol 1992; 114: 776.
Frieman BJ, Friedberg MA . Globe perforation associated with sub-tenon's anesthesia. Am J Ophthalmol 2001; 131: 520–521.
Olitsky SE, Juneja RG . Orbital haemorrhage after the administration of sub-Tenon's infusion anaesthesia. Ophthalmic Surg Lasers 1997; 28: 145–146.
Spierer A, Schwalb E . Superior oblique muscle paresis after sub-Tenon's anesthesia for cataract surgery. J Cataract Refract Surg 1999; 25: 144–145.
Jaycock PD, Mather CM, Ferris JD, Kirkpatrick JNP . Rectus muscle trauma complicating sub-Tenon's local anaesthesia. Eye 2001; 15: 583–586.
Ntim-Amponsah CT . Evaluation of Greenbaum's anaesthetic technique using lignocaine with adrenaline. West African J Med 1998; 17: 144–147.
Kumar CM, Dodds C . An anaesthetic evaluation of Greenbaum sub-Tenon block. British J Anaesth 2001; 87: 631–633.
Stevens JD, Restori M . Ultrasound imaging of no needle 1-quadrant sub-Tenon local anaesthesia for cataract surgery. Eur J Implant Refract Surg 1993; 5: 35–38.
Winder S, Atta HR . Ultrasonic localization of anaesthetic fluid in sub-Tenon's, peribulbar, and retrobulbar techniques. J Cataract Refract Surg 1999; 25: 56–59.
Roman SJ, Chong Sit DA, Boureau CM, Auclin FX, Ullern MM . Sub-Tenon's anaesthesia: an efficient and safe technique. Br J Ophthalmol 1997; 81: 673–676.
Tokuda Y, Oshika T, Amano S, Yoshitomi F, Inouye J . Anaesthetic dose and analgesic effects of sub-Tenon's anaesthesia. J Cataract Refract Surg 1999; 25: 1250–1253.
Verghese I, Sivraj P, Lai YK . The effectiveness of sub-Tenon's infiltration of local anaesthesia for cataract surgery. Aust N Z J Ophthalmol 1996; 24: 117–120.
Zafirakis P, Voudouri A, Rowe S, Livir-Rallatos G, Livir-Rallatos C, Canakis C et al. Topical versus sub-Tenon's anaesthesia without sedation in cataract surgery. J Cataract Refract Surgery 2001; 27: 873–879.
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This study was presented at the annual meeting of the Ophthalmic Anesthesia Society in Chicago, IL, USA on 7th October 2001
The authors have no financial interest in the cannula or any other product mentioned
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Kumar, C., McNeela, B. Ultrasonic localization of anaesthetic fluid using sub-Tenon's cannulae of three different lengths. Eye 17, 1003–1007 (2003). https://doi.org/10.1038/sj.eye.6700501
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DOI: https://doi.org/10.1038/sj.eye.6700501
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