Abstract
Aim: To compare the efficacy and safety of medial canthus single injection with the classic double injection peribulbar anaesthesia (PBA) technique for cataract surgery. Materials and Methods: A prospective, randomised, controlled, double-masked study was conducted at National Eye Centre, Kaduna, Nigeria between October and December 2012. One hundred patients with age-related cataracts were allocated into two equal groups. Anaesthesia was administered by an anaesthetic nurse using a mixture of xylocaine 2% + adrenaline 0.125 mg/ml + hyaluronidase 15 IU/ml with a 23G, 32 mm needle. Group 1 received a single injection into the inferomedial orbital quadrant, whereas Group 2 received two injections into the inferotemporal and superonasal quadrants. Primary outcome measures were time to achieve adequate akinesia; supplementary injections; pain of injection and surgery. Secondary outcomes were number of injections; volume of anaesthetic; complications; surgery duration; surgeon’s satisfaction. Data were analysed using the Statistical Package for the Social Sciences version 16.0 software (SPSS Inc., Chicago). Results: In each group, 82% of patients achieved adequate akinesia within 10 min of the initial injection(s). No pain was felt during the injection by 40 and 50% of patients in Groups 1 and 2, respectively; and by 96% in both groups during surgery. Chemosis occurred in 14 patients in Group 2 and none in Group 1 (P ≤ 0.001). Mean number of injections in Group 2 was 2.18 ± 0.39 versus 1.18 ± 0.39 in Group 1 (P ≤ 0.001). Median score for surgeon’s satisfaction was ‘excellent’ for both the groups. Conclusion: Single injection PBA was as good as the double injection technique in providing adequate conditions for surgery; while reducing the risks of needle-related complications.
Published Version
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