Parabulba (Flush ) Method of local Anesthesia In Cataract surgery

Abstract

Eye surgery under local anesthesia becomes a subject of Interest for many researches. This is attributed to the fact that it is simple, cheaper and less complicating than doing it under general anesthesia. Also due to the trend of outpatient cataract surgery. So it was important to modify local anesthetic methods to be much more easy, efficient in anesthesia and akinesia, and less complicating that may occur with retrobulbar and peribulbar anesthesia including retrobulbar hemorrhage, ocular perforation

, injury to optic nerve or its sheath , central retinal artery occlusion, ineffective anesthesia and many other local or systemic complications . So, sub-Tenon's anesthesia came up;in which the anesthesia is injected under Tenon's capsule by special metal cannula, this technique, however, did not, gain popularity perhaps because the blunt needle used was of metal and one could still perforate a staphylomatous myopic eye. this

would be unusual but disastrous if it Occurred .

Aleman C.F, et al," have presented a series of 70 cases using the Greenbaum flexible cannula with flush or parabulbar anesthesia for different techniques involving anterior and posterior segment surgery, but mainly anterior segment operations. The Greenbaum anesthesia cannula is made of polyethelene. It is flexible

and atrumatic; it has a rounded, blunt tip.

Dr. Aleman"has found this to be a highly safe procedure, with practically no risk of globe perforation or retrobulbar hemorrhage and it has eliminated the use of metal needles . She has found this technique easier to perform than. the retrobulbar and peribulbur methods , equally effective than the peribulbar method. Analgesia is Immediate and very effective Akinesia however takes place between 3-5 minutes. The pre and trans operative sedation can be cut in half.