Analgesic effects of sub-Tenon’s versus retrobulbar anesthesia in planned extracapsular cataract extraction

Abstract 

Background: A prospective study was conducted to compare the analgesic effects of sub-Tenon’s and retrobulbar anesthesia by assessing patients’ response to the visceral stimulus. Methods: Seven hundred and twenty eyes of 720 patients underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation. They received retrobulbar anesthesia with 3 ml lidocaine (225 eyes), retrobulbar anesthesia with 5 ml lidocaine (216 eyes), or sub-Tenon’s anesthesia with 3 ml lidocaine (279 eyes). Pain scores were recorded when an acetylcholine chloride solution was injected into the anterior chamber to attain miosis after lens implantation. Results: Pain scores were significantly different among the three anesthesia groups (P<0.0001, Kruskal-Wallis test). The multiple comparison revealed that analgesic effects were highest with sub-Tenon’s anesthesia, followed by 5-ml retrobulbar and 3-ml retrobulbar anesthesia. Conclusion: Sub-Tenon’s anesthesia is an effective and reliable anesthetic method in cataract surgery.