Peribulbar anesthesia in sclero-retinal surgery: two quadrants vs single injection

Purpose. To evaluate the advantage of peribulbar anesthesia in two quadrants (infero-temporal and upper nasal) vs single injection tedchnique (infero-temporal) for scleral rhegmatogenous detachment surgery (RRD). Patiets and methods. 57 patients, aged between 33 and 75 years (57.01 + - 8.68), waiting for retinal detachment surgery, were randomized in two gruops: a group S (29 patients), with single quadrant injection technique and a group C (28 patients) with two quadrants injection. Patients in Group S were injected in two quadrants with a 10 ml mixture containing Mepivacaine 2% 5ml and Ropivacaine 0.75% 5ml, with hyaluronidase 10UI/ml. Patients in group C were injected with the same mixture in one quadrant. Number of additional injections, during surgery, in two groups, were reported. Pain was tested with VAS (Verbal Analogue Scale 0-10) after regional block, when muscles were insulated, during scleral buckling positioning, when conjunctive was closed and 6, 12, 24 hours after surgery. Results. The need for a second peribulbar injection of anesthetic occurred in 9 patients of group C (32.14%); further injection was necessary in 1 patient (3.57%) of group S during scleral buckling (VAS=7), statistically significant p<0.05). Postoperative VAS 6-12-24 hours after surgery was not significant. Conclusions. The peribulbar anesthesia may be proposed in scleral surgery of retinal detachment; the injection in two quadrants secured solid and satisfectory anesthesia, increasing the outcome of retinal surgery in loco-regional anesthesia.