Study of Two-step Anesthesia in Posterior Vitrectomy

A Prospective, Randomised, Single-masked Comparison of Retrobulbar Anesthesia, Peribulbar Anesthesia and Topical Combined Subconjunctival(Two-step) Anesthesia in Posterior Vitrectomy

A prospective, randomised, single-masked comparison of local anaesthetic approaches including topical anesthesia combined sub-conjunctival anesthesia(two-step anesthesia) for minimally invasive vitrectomy（TAMIV）vs peribulbar block vs retrobulbar block

Purpose: topical anesthesia combined sub-conjunctival anesthesia(two-step anesthesia) for minimally invasive vitrectomy Methods: This prospective, randomized, single-blinded clinical trail is conducted at Shanghai Aier Eye Hospital. Selected group of 60 patients with retinal-vitreous diseases will be randomized divided into 3 groups and underwent 25-gauge vitrectomy. Group1 uses two-step anesthesia , whereas Group 2 uses retrobulbar anesthesia, group 3 uses peribulbar anesthesia. A 5-point Visual Analogue Pain Scale is used to assess patients' pain score and surgeon's ease while operating. Any complications therefore will be made note of.

Inclusion Criteria:

• Proliferative diabetic retinopathy (PDR);
• Vitreous haemorrhage (VH);
• Retinal detachment (RD);
• Retinal vein occlusion(RVO);
• Other diseases (idiopathic macular hole, macular pucker and high myopic maculopathy);
• Silicone oil-filled eye.

Exclusion Criteria:

• Communication problems;
• Allergy to amide-type local anaesthetic agents;
• History of vitreoretinal surgery or orbital surgery;
• Orbital deformity;
• With episcleral adjunct surgery;
• Trauma;
• Keratitis;
• Conjunctivitis and active uveitis.