PROLONGED PERIBULBAR ANESTHESIA WITH INDWELLING CATHETER - A PRELIMINARY-REPORT OF 217 CASES

We report a technique to prolong peribulbar anaesthesia by repetitive injections of lignocaine through a catheter in the inferotemporal peri bulbar space during surgery anticipated to exceed 60 min. After peribu lbar anaesthesia by standard percutaneous approach with the eye lookin g straight, a 19-gauge Tuohy needle was inserted backwards in the sagi ttal plane and parallel to the 5 degrees slope of the orbit floor, to a distance of less than 3 cm, at the junction of the middle and latera l third of the lower orbital rim. A 23-gauge smooth catheter was advan ced up to the tip of the needle which was withdrawn, keeping less than 3 cm of catheter in the inferotemporal compartment. A catheter was in serted in 217 consecutive patients undergoing vitrectomy, retinal deta chment and retinal peeling. There were no technical difficulties. Neit her additional sedation nor general anaesthesia was required during su rgery, but less than 50% of patients requested lignocaine injections t o supplement anaesthesia. Catheter insertion into the peribulbar space may represent a potential technique to perform a greater variety of o phthalmic surgery with regional anaesthesia. Indications should be lim ited to the longest procedures.