Efficacy of regional anesthesia in episcleral surgery: a randomized controlled double-blind clinical study

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Abstract

BACKGROUND: Surgical interventions for severe fundus diseases associated with diabetes mellitus, proliferative processes against the background of retinal detachment, and acute inflammatory diseases require the development of multimodal algorithms to provide sufficient analgesic and anti-inflammatory effects.

AIM: To evaluate the efficacy of combined pterygopalatine blockade (PPB) and retrobulbar blockade (RBB) in patients with episcleral retinal detachment surgery.

MATERIALS AND METHODS: The study included 100 patients who underwent episcleral surgery for retinal detachment. All patients were randomized into two groups: group 1 (retrobulbar blockade, n=50) and group 2 (pterygopalatine blockade in combination with retrobulbar blockade, n=50). The level of akinesia, volume of local anesthetic, consumption of analgesics, pain, and postoperative nausea and vomiting (PONV) were evaluated.

RESULTS: In group 2, only 12% of the patients were prescribed promedol 2% intraoperatively, which is significantly lower than that in group 1 (p=0.463). In group 2, the pain level 8 h after surgery according to the verbal sensation scale was 0.8±0.63. In group 1, the average pain score was 1.69±1.8 (p=0.558). PONV was observed in 4% of the patients in group 1. In group 2, no PONV occurred (p=0.563).

CONCLUSION: The combination of PPB and RBB allows for controlling not only pain sensitivity but also vegetative, motor, and neuroendocrine manifestations associated with pain both in the intraoperative and early postoperative periods.

About the authors

Irina G. Oleshchenko

Irkutsk branch of S.N. Fyodorov «Eye microsurgery» Federal State Institution; Irkutsk State Medical University

Author for correspondence.
Email: iga.oleshenko@mail.ru
ORCID iD: 0000-0003-1642-5276
SPIN-code: 8824-1216

MD, Cand. Sci. (Med.)

Russian Federation, Irkutsk; Irkutsk

Aleksandr V. Mankov

Irkutsk State Medical University

Email: man-aleksandrv@yandex.ru
ORCID iD: 0000-0001-8701-6432
SPIN-code: 7135-2828

MD, Cand. Sci. (Med.)

Irkutsk

Sergey S. Belyaev

Irkutsk branch of S.N. Fyodorov «Eye microsurgery» Federal State Institution

Email: dr.beliaev2016@yandex.ru
ORCID iD: 0000-0002-0508-4333

anesthesiologist-resuscitator

Russian Federation, Irkutsk

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