An Overview of Ultrasound-guided Peribulbar Block with Blunt Canula for Cataract Surgery

Abstract

Cataract surgery is one of the most common procedures executed worldwide. There are various options for anaesthetic management, with so many factors influencing the choice of any given technique, based on the requirements of the patient, the choices of the surgeon, and the institutional facilities and processes. Despite being more invasive than topic anaesthesia and having potentially dangerous side effects, peribulbar block is an efficient and effective technique. Peribulbar anesthesia is largely utilized for eye surgery, in many subspecialities, as glaucoma, corneal, vitreo-retinal and cataract surgery. The use of a blunt canula and ultrasound guidance may improve the safety pattern for this method. From February 2016 to January 2022, 1089 consecutive cases of patients undergoing cataract surgery under peribulbar anaesthesia with blunt canula and ultrasound guidance were reviewed. There were 1318 surgical records chosen, with 1089 meeting the inclusion criteria. There was greater prevalence of the feminine gender (54%), with the median age of 64.3 (28-102) years. Mean IAV was 2.9mL (sd 0,16mL, 2.5 – 3.0mL), with total HOS 91.1%; OR to reach G2 or above for each (ISB/IMB) was 11.0; CA was 47.9%, with mean FAV of 4.29mL (sd 2.17mL, 2.5-15mL); In 8.9% patients, HOS could not be fully noticed. ISB, IMB, CA e FAV were calculated to both groups (non-HOS and HOS-only). OR for CA (non-HOS/HOS-only) was 126.21. There was no procedure postponement due to an anesthesia-related adverse event. This study suggests that the described technique is feasible in an outpatient setting, with low, mild, and tolerable side effects.