PERIBULBAR ANESTHESIA - TRANSCUTANEOUS OR TRANSCONJUNCTIVAL

Background: Transconjunctival peribulbar anesthesia is reported to per mit better identification of the bulbar limits because of a better vie w into the fornix; it is also said to be less painful compared to tran scutaneous peribulbar anesthesia. The aim of our study was to compare the two injection techniques. Patients and methods:This study comprise d 46 patients undergoing eye operations under local anesthesia. They w ere allocated randomly in a prospective and simple masked study. Twent y-three patients received transconjunctival injections and 23 patients transcutaneous peribulbar injections. Before injection,all patients r eceived Oxybuprocain eyedrops for anesthesia of the conjunctiva. In al l cases no separate injections for lid akinesia were performed. Before and 20 min after the injection, the following parameters were assesse d: pain score (visual analog scale),frequency of conjunctival chemosis and the necessity for supplemental anesthesia. For identification of the bulbar limits we checked if it was possible to see the caudal and the cranial fornix. Results: The transconjunctival injection was signi ficantly (P=0.05) more painful (5.6+/-2.4) than the transcutaneous inj ection (4.2+/-2.4). Among the patients with transconjunctival injectio n, in 66.6% the cranial fornix could not or was only poorly seen. Conc lusions:Transconjunctival peribulbar anesthesia appears not to be more advantageous than transcutaneous peribulbar anesthesia.