Parabulbar anesthesia for primary vitreoretinal surgery

Purpose: The efficacy and safety of parabulbar anesthesia was investigated prospectively in 100 patients undergoing primary vitreoretinal surgery. Methods: The technique involved three steps: (1) orbicularis oculi injection, (2) subconjunctival injection, and (3) sub-Tenon irrigation. The effect of anesthesia was graded 0 to 5 depending on inadequate anesthesia-akinesia with or without local supplementation. Ninety-three patients underwent vitrectomy without buckling and 4 with an encircling band; 3 had scleral buckling. Mean duration of surgery was 89.38 minutes. Results: In 69% of patients (grades 4 and 5), no supplementation was required and in 31% (grades 1-3), local supplementation was needed for inadequate anesthesia or akinesia or both. No ocular or systemic complication occurred. Early onset of anesthesia correlated: with adequate anesthesia throughout the procedure (P < 0.04). Conclusions: Parabulbar anesthesia is a safe and effective technique of local anesthesia in patients undergoing primary vitreoretinal surgery.