Cataract surgery anaesthesia: Is topical anaesthesia really better than retrobulbar?

Katalin Gombos, Edit Jakubovits, Agoston Kolos, György Salacz, J. Németh

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: To compare the effectiveness for the patient of retrobulbar anaesthesia (RBA) and topical anaesthesia (TA) in cataract surgery by phacoemulsification. Methods: We performed a prospective, randomized study on 115 patients operated at our clinic using the two anaesthesia techniques. The RBA group comprised 57 patients (20 women, 37 men; age 72 ± 10 years); the TA group comprised 58 patients (20 women, 38 men; age 74 ± 10 years). Measured parameters were: blood pressure; heart rate; blood oxygen saturation level; serum adrenaline, noradrenaline and cortisol levels; white blood cell count; indicated pain during the procedure, and pain as reported by the patient afterwards. Two psychological tests were used: the State-Trait Anxiety Inventory (STAI), and the patient-selected face-scale test. Statistical analysis was performed using Student's t-test and the chi-square test. Results were also analysed using a logistic regression model. Results: Both types of anaesthesia were adequate for the surgical procedure. In the RBA group fewer patients experienced pain during surgery (p <0.01) and fewer recalled any perioperative discomfort. With RBA the objective parameters were more stable than with TA, and systolic blood pressure was significantly lower (p = 0.01). The logistic model was able to predict perioperative pain with 93% certainty. Pain sensitivity was higher in younger patients and in patients with higher initial cortisol and noradrenaline serum levels. Conclusions: Both methods of anaesthesia are appropriate, but phacoemulsification with TA is more painful than with RBA. In hypertonic patients and younger patients who are more susceptible to pain, TA should be avoided or used in combination with individualized sedation.

Original languageEnglish
Pages (from-to)309-316
Number of pages8
JournalActa Ophthalmologica Scandinavica
Volume85
Issue number3
DOIs
Publication statusPublished - May 2007

Fingerprint

Cataract
Anesthesia
Pain
Phacoemulsification
Logistic Models
Blood Pressure
Hydrocortisone
Norepinephrine
Psychological Tests
Chi-Square Distribution
Serum
Leukocyte Count
Epinephrine
Anxiety
Heart Rate
Prospective Studies
Students
Oxygen
Equipment and Supplies

Keywords

  • Adrenocortical system
  • Pain
  • Phacoemulsification
  • Psychological tests
  • RBA (retrobulbar anaesthesia)
  • TA (topical anaesthesia)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Cataract surgery anaesthesia : Is topical anaesthesia really better than retrobulbar? / Gombos, Katalin; Jakubovits, Edit; Kolos, Agoston; Salacz, György; Németh, J.

In: Acta Ophthalmologica Scandinavica, Vol. 85, No. 3, 05.2007, p. 309-316.

Research output: Contribution to journalArticle

Gombos, Katalin ; Jakubovits, Edit ; Kolos, Agoston ; Salacz, György ; Németh, J. / Cataract surgery anaesthesia : Is topical anaesthesia really better than retrobulbar?. In: Acta Ophthalmologica Scandinavica. 2007 ; Vol. 85, No. 3. pp. 309-316.
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