Skip to main content Accessibility help
×
Home

A comparison of infero-nasal and infero-temporal sub-Tenon's block

  • H. McLure (a1), C. M. Kumar (a2), S. Williamson (a2), S. Batta (a2), R. Chabria (a2) and S. Ahmed (a1)...

Extract

Summary

Background and objective: Sub-Tenon's block is usually delivered by the infero-nasal (IN) approach, but occasionally this may not be possible. The infero-temporal (IT) approach has been described, but data is not available on its efficacy. Methods: One hundred patients undergoing cataract extraction were randomized to receive an IN or IT sub-Tenon's injection of lidocaine 2% with hyaluronidase 15 IU mL−1. Akinesia was assessed using the Brahma scale at 0, 2, 4, 6 and 8 min. Injection, intraoperative and postoperative pain scores (verbal analogue score, 0–10) were noted, along with the incidence of sub-conjunctival haemorrhage and chemosis. Results: There were no differences in patient characteristics data, or mean volume of administered local anaesthetic solution (3.3 (SD = 0.4) mL). There were no significant differences between groups in terms of onset of akinesia. Mean akinesia scores at 2, 4, 6 and 8 min were 2.7, 1.1, 0.4 and 0.2 for Group IN, compared to 2.2, 0.9, 0.8 and 0.3 for Group IT. Chemosis occurred in 14 patients in Group IN, compared to 22 in Group IT (P = 0.21).A sub-conjunctival haemorrhage was noted in 14 patients in Group IN and 19 patients in Group IT (P = 0.52). No patients required supplementary injections. Mean pain scores for the injection, intraoperatively and postoperatively were 0.9, 0 and 0 for Group IN, compared to 1.1, 0 and 0 for group IT. The surgeons scored all the blocks as ‘good’ except for one patient in each group. Conclusions: The IT approach provides an equally rapid onset of block, without a significant increase in complications.

Copyright

Corresponding author

Correspondence to: Chandra. M. Kumar, Academic Department of Anaesthesia, The James Cook University Hospital, Middlesbrough TS4 3BW, UK. E-mail: Chandra.kumar@stees.nhs.uk; Tel: +44 1 64 285 4600; Fax: +44 1 64 285 4246

Footnotes

Hide All
The abstract of this study was presented in the Annual Scientific Meeting of the European Society of Anaesthesiologists, Vienna, May 2005.

Footnotes

References

Hide All

References

Eke T, Thompson J. The National Survey of Local Anaesthesia for ocular surgery: survey methodology and current practice. Eye 1999; 13: 189195.
Canavan K, Dark A, Garrioch M. Sub-Tenon's administration of local anaesthetic: a review of the technique. Br J Anaesth 2003; 90: 787793.
Kumar CM, Williamson S, Manickam B. A review of sub-Tenon's block: current practice and recent development. Eur J Anaesthesiol 2005; 22: 567577.
Stevens J. A new local anaesthesia technique for cataract extraction by one quadrant sub-Tenon's infiltration. Br J Ophthalmol 1992; 76: 670674.
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: 673676.
Brahma A, Pemberton C, Ayeko M, Morgan L. Single medial injection peribulbar anaesthesia using prilocaine. Anaesthesia 1994; 49: 10031005.
Bron AJ, Tripathi R, Tripathi B. Wolf's Anatomy of the Eye and Orbit. London: Chapman and Hall, 1997: 147.
Fischer HBJ, Pinnock CA. Fundamentals of Regional Anaesthesia. UK: Cambridge University Press, 2004: 103111.
Kumar CM, Dodds C, Fanning GL. Ophthalmic Anaesthesia. The Netherlands: Swets and Zeitlinger, 2002: 66.
Fukasaku H, Marron JA. Sub-Tenon's pinpoint anesthesia. J Cataract Refract Surg 1994; 20: 468471.
Ripart J, Lefrant JY, Lalourcey L et al. Medial canthus (caruncle) single injection periocular anesthesia. Anesth Analg 1996; 83: 12341238.
Ripart J, Metge L, Prat-Pradal D, Lopez FM, Eledjam JJ. Medial canthus single-injection episcleral (sub-Tenon anesthesia): computed tomography imaging. Anesth Analg 1998; 87: 4245.
Ripart J, Prat-Pradal D, Vivien B, Charavel P, Eledjam JJ. Medial canthus episcleral (sub-Tenon) anesthesia imaging. Clin Anat 1998; 11: 390395.
Ripart J, Lefrant JY, Vivien B et al. Ophthalmic regional anesthesia: medial canthus episcleral (sub-Tenon) anesthesia is more efficient than peribulbar anesthesia: a double-blind randomized study. Anesthesiology 2000; 92: 12781285.
Ripart J, Lefrant JY, L'Hermite J et al. Caruncle single injection episcleral (sub-Tenon) anesthesia for cataract surgery: mepivacaine vs. a lidocaine–bupivacaine mixture. Anesth Analg 2000; 91: 107109.
Nouvellon E, L'Hermite J, Chaumeron A et al. Ophthalmic regional anesthesia: medial canthus episcleral (sub-Tenon) single injection block. Anesthesiology 2004; 100: 370374.

Keywords

Related content

Powered by UNSILO

A comparison of infero-nasal and infero-temporal sub-Tenon's block

  • H. McLure (a1), C. M. Kumar (a2), S. Williamson (a2), S. Batta (a2), R. Chabria (a2) and S. Ahmed (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.