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Global Translational Medicine

ORIGINAL RESEARCH ARTICLE
Local anesthesia in 23-gauge vitreoretinal

surgery: A comparison of efficacy between
retrobulbar and sub-Tenon’s injection

1
Fatemeh Golsoorat Pahlaviani , Fardin Yousefshahi , Hanieh Niktinat ,
2
1
Ramak Roohipourmoallai , Samaneh Davoudi , Siva S. R. Iyer ,
5
4
3
Samaneh Bourbour , and Nazanin Ebrahimiadib *
6
1
1 Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
2 Hospital Hôtel-Dieu de Sorel, CISSS de la Montérégie-Est, Quebec, Canada
3 Department of Ophthalmology, Morsani Hospital, University of South Florida, Florida, United States of
America
4 Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts, United
States of America
5 Vitreoretinal Associates, Gainesville, Florida, United States of America
6 Department of Ophthalmology, University of Florida, Gainesville, Florida, United States of America

Abstract
This study aimed to compare sub-Tenon’s and retrobulbar blocks during vitreoretinal
surgery in terms of postoperative pain and surgeon experience. This prospective study
included 53 patients scheduled for 23-gauge pars plana vitrectomy under local anesthesia.
Patients were nonrandomly assigned to receive a xylocaine injection through either the
*Corresponding author: transconjunctival sub-Tenon’s or retrobulbar routes, supplemented with intravenous (IV)
Nazanin Ebrahimiadib sedation (midazolam + fentanyl). A sharp needle was used for both techniques. In the sub-
E-mail: nebrahimiadib@ufl.edu Tenon’s group, anesthetic injection was initiated through subconjunctival administration
Citation: Pahlaviani FG, after prepping and draping. Pain was assessed immediately postsurgery and the following
Yousefshahi F, Niktinat H, et al. day using a standardized questionnaire. Patient and surgeon satisfaction levels, along
Local anesthesia in 23-gauge
vitreoretinal surgery: A comparison with complications in each group, were recorded. Of the 53 patients, 42 (79%) received
of efficacy between retrobulbar and the sub-Tenon’s block and 11 (21%) received the retrobulbar block. No statistically
sub-Tenon’s injection. Global Transl significant differences in pain scores, patient satisfaction, or surgeon satisfaction were
Med. 2024:3(4):3900.
doi: 10.36922/gtm.3900 found between the groups. Postoperative pain and surgeon satisfaction were negatively
correlated in both groups (B = −0.465; P < 0.001), and a moderate-to-high correlation
Received: June 9, 2024 was observed between patient and surgeon satisfaction (B = 0.686; P < 0.001). Overall,
Accepted: October 21, 2024
Published Online: November 14, sub-Tenon’s and retrobulbar blocks showed comparable effectiveness in terms of
2024 postoperative pain and patient and surgeon satisfaction in vitreoretinal surgery, with no
Copyright: © 2024 Author(s). significant differences in outcomes or complication rates.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution Keywords: Retrobulbar block; Sub-Tenon’s; Vitreoretinal surgery; Local anesthesia;
License, permitting distribution, 23-gauge vitrectomy; Ocular pain questionnaire
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional In ophthalmic surgery, anesthesia not only relieves pain but also facilitates extraocular
1
affiliations. muscle akinesia. An increasing preference for local anesthesia in ophthalmic surgeries
Volume 3 Issue 4 (2024) 1 doi: 10.36922/gtm.3900