Combined propofol sedation with sub-Tenon's lidocaine/mercaine infusion for strabismus surgery in adults.

Abstract

AIMS:

To evaluate the safety and efficacy of propofol sedation combined with sub-Tenon's anaesthesia for strabismus surgery in adults.

METHODS:

Thirty-two consecutive patients aged 31-85 years underwent strabismus surgery under general (n=16) or local (n=16) anaesthesia. In the local anaesthesia (study) group, sedation was induced with a loading dose of midazolam, fentanyl, and propofol, followed by continuous infusion of propofol, 3-6 mg/k/h to deep sedation. A nasal tube was inserted to prevent airway obstruction. Sub-Tenon's anaesthesia included infusion of a 3-4 ml mixture (50 : 50) of lidocaine 2%/mercaine 0.5%. General anaesthesia consisted of premedication with midazolam, followed by fentanyl, esmeron-bromate, propofol, and tracheal intubation. Duration of surgery and anaesthesia, intraoperative oculocardiac reflex and arrhythmias, time to discharge, postoperative pain, nausea and vomiting, and patient and surgeon satisfaction were evaluated.

RESULTS:

The local anaesthesia group had a significantly shorter operative and anaesthesia time, fewer episodes of oculocardiac reflex or arrythmia/bradycardia requiring treatment, fewer early or late episodes of nausea and vomiting, and less pain. The patients and surgeon in this group reported higher satisfaction.

CONCLUSION:

Propofol sedation with local sub-Tenon's injection of lidocaine/mercaine is recommended for the induction and maintenance of anaesthesia during unilateral or bilateral strabismus surgery in adults. The method is quick and effective, without systemic or ocular side effects.

• Authors: M Snir, M Bachar, J Katz, R Friling, D Weinberger, R Axer-Siegel
• Journal: Eye (London, England) (Eye (Lond)) Vol. 21 Issue 9 Pg. 1155-61 (Sep 2007) ISSN: 0950-222X [Print] England
• PMID: 16732214 (Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Anesthetics, Combined
• Anesthetics, Local
• Lidocaine
• Bupivacaine
• Propofol

Topics

• Adult
• Aged
• Aged, 80 and over
• Anesthesia, General (methods)
• Anesthesia, Local (methods)
• Anesthetics, Combined (administration & dosage)
• Anesthetics, Local (administration & dosage)
• Attitude of Health Personnel
• Bupivacaine (administration & dosage)
• Deep Sedation (methods)
• Female
• Humans
• Intraoperative Complications
• Intraoperative Period
• Length of Stay
• Lidocaine (administration & dosage)
• Male
• Middle Aged
• Pain Measurement
• Pain, Postoperative
• Patient Satisfaction
• Postoperative Complications
• Postoperative Nausea and Vomiting (etiology)
• Propofol
• Strabismus (surgery)