Periocular Versus General Anesthesia for Ocular Enucleation

Abstract

To compare the morbidity of general anesthesia versus periocular anesthesia with monitored intravenous sedation for enucleation of the eye. A retrospective study of 39 patients who underwent enucleation. For anesthesia during enucleation, 21 patients received periocular anesthesia with monitored intravenous sedation and 18 patients received general anesthesia. During recovery on the day of surgery, 94% (17/18) of general anesthesia patients required postoperative analgesics, compared with 52% (11/21) of periocular anesthesia with monitored intravenous sedation patients (p = 0.0046). Postoperative antiemetic treatment of nausea and vomiting on the day of surgery was required in 56% (10/18) of general anesthesia patients, but only 5% (1/21) of periocular anesthesia with monitored intravenous sedation patients (p = 0.0008). On contacting these patients, no patients receiving periocular anesthesia with monitored intravenous sedation had a negative memory of the surgery and all but 2 indicated they would elect the same type of anesthesia in retrospect. Periocular anesthesia with monitored intravenous sedation related costs were substantially less than those associated with general anesthesia. Periocular anesthesia with monitored intravenous sedation for enucleation reduces early postoperative morbidity and is more cost effective than general anesthesia. It is an anesthetic alternative that should be considered for patients undergoing enucleation of the eye.