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BACKGROUND AND OBJECTIVE: We compared the effects of sub-Tenon's local anaesthetic block and placebo on peri-operative opioid requirement and cardiovascular stability and on postoperative pain, nausea and vomiting in patients undergoing vitreo-retinal surgery under general anaesthesia. METHODS: We studied 43 patients undergoing vitreo-retinal surgery under general anaesthesia in a randomized double blind study. Patients received a standard general anaesthetic followed by a sub-Tenon's injection of 4-5 mL of either bupivacaine 0.75% or saline. We recorded intraoperative invasive arterial pressure, then the incidence and severity of pain and of nausea and vomiting, for 24 h postoperatively. RESULTS: In the sub-Tenon's bupivacaine group, there was a significant reduction in the perioperative opioid use and a reduction in the frequency of bradycardia and hypertensive episodes, defined as a rise > 25% of baseline for a duration of > 3 min. The sub-Tenon's bupivacaine group also had significantly lower pain scores and nausea scores at 12 h, concomitant with a lower consumption of analgesia and antiemetics. CONCLUSIONS: This local anaesthetic technique is effective in vitreo-retinal surgery and can be safely applied to this population of patients regardless of axial length.

Type

Journal article

Journal

Eur J Anaesthesiol

Publication Date

12/2003

Volume

20

Pages

973 - 978

Keywords

Acetaminophen, Aged, Analgesics, Analgesics, Non-Narcotic, Analgesics, Opioid, Anesthesia, General, Anesthesia, Local, Anesthetics, Local, Blood Pressure, Bradycardia, Bupivacaine, Codeine, Dose-Response Relationship, Drug, Double-Blind Method, Humans, Hypertension, Middle Aged, Odds Ratio, Ophthalmologic Surgical Procedures, Pain, Postoperative, Perioperative Care, Postoperative Nausea and Vomiting