Episcleral approach as a recent trend of regional anaesthesia for eye surgeries

Abstract

Local anesthesia is a commonly used technique for the ophthalmic surgery. It is safe, has high success rate and is preferred by most of the patients. It has many advantages over general anesthesia such as avoidance of difficult airway, less intraoperative bleeding, greater cardiovascular stability, reduced metabolic disturbances, minimum chances of postoperative nausea, vomiting, coughing and respiratory complications. It avoids the need for analgesia in the immediate postoperative period and is also cost-effective. Additional advantages are early mobilization, return to oral diet, and discharge from hospital. Quicker patient rehabilitation and fewer complications are the main reasons why many ophthalmic surgeons are choosing local (LA) over general anesthesia. .These factors have special advantage in geriatric patients with multiple co-morbidities.

The ideal block provides a painless, hypotonic, still eye with rapid return of function once the surgery has been completed. Techniques vary from simple application of local anaesthetic drops to semi-surgical techniques involving incision and dissection of the orbital tissues.