A comparative study of subtenon’s anaesthesia with peribulbar anaesthesia for manual small incision cataract surgery in patients with age related cataracts

Abstract

To compare the safety, efficacy and ease of administration of subtenon’s anaesthesia with peribulbar anaesthesia in manual small incision cataract surgery(MSICS) and assess the surgeon and patient comfort.A prospective longitudinal study was conducted among 200 patients undergoing MSICS at a rural tertiary care hospital wherein patients were randomly divided into the two groups of peribulbar (P) and subtenon’s (ST) block.After randomization, 200 patients were assessed for various factors including pain at the time of administration of anaesthetic, time to attain akinesia, patient’s comfort and satisfaction score.200 eyes of 200 patients who underwent MSCIS were divided into Peribulbar and Subtenon’s group by random number table; of which 122 were women (61%) and 78 were men (39%). There was a significant difference in the amount of anaesthetic used, with the group P (8.37+1.19 ml) usage being more than the group ST(4.02+0.91 ml) (p<0.001). Group P took significantly lesser time to attain akinesia compared to group ST. Group P achieved significantly higher degree of akinesia than group ST. (p<0.001) Significantly greater number of eyes in the group ST required additional anaesthetic injection compared to the group P (p<0.001). A significantly more number of patients experienced pain in the group P. (p=0.008)Significantly greater number of eyes in group ST had mild and moderate chemosis and subconjunctival haemorrhage compared to group P(p<0.001).We found that subtenon’s anaesthesia was an equally effective technique for achieving analgesia and akinesia when compared to peribulbar anaesthesia in patients undergoing MSICS.