Comparative study between medial canthus episcleral block versus peribulbar block in intracapsular cataract surgery

Abstract

Ophthalmic regional anesthesia became the main standard plan for ophthalmic surgery and replaced general anesthesia in the majority of cases. The ophthalmic regional anesthesia took the upper hand in patients with comorbid diseases; it is accompanied with negligible effects on the hemodynamic profile and avoids other side effects such as respiratory depression postoperative nausea and vomiting. It also provides better postoperative analgesia. There are different techniques of ophthalmic regional anesthesia according to the site were the needle is inserted and the local anesthetic is injected. In the past the RBA was the gold standard in which the local anesthetic is injected inside the extraocular muscles cone behind the globe which was highly effective but was accompanied by dangerous complications. PBA then replaced the RBA for its higher safety profile in which the needle is introduced outside muscle cone away from the neurovascular vital structures and the globe, the local anesthetic is injected in the adipose tissue inside the orbit and diffuses inside the muscle cone by the compartment theory. It is less effective than RBA but more safe.