Retina-Vitreous
2011 , Vol 19 , Num 4
Comparison of the Effects of Sub-Tenon Prilocain and Combination of Prilocain and Bupivacain on Pain in Vitreoretinal Surgery
1İstanbul Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Asist. Dr.2İstanbul Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Uz. Dr.
3İstanbul Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Doç. Dr. Purpose: To compare the effects of subtenon prilocain and combination of prilocain and bupivacain on pain score by patients used for vitreoretinal surgery.
Materials and Methods: In this prospective study we divided 50 patients undergoing vitreoretinal surgery into two subgroups between March 2009 and October 2010 in İstanbul Education and Reserch Hospital Eye Clinic. In Group I, all cases received 3 ml prilocain 2%, in Group II, mixture of 2 ml prilocain 2% and 1ml bupivacain 0.5%injected under Tenon in inferonasal quadrant. 10 points visual analog pain scale was used to evaluate the pain and anesthesic block efficiency. The results were evaluated by using Chi square and Mann Whitney-U tests . P<0.05 is accepted as statistically significant.
Results: The mean age of patients was 58.32±7.68 (46-76) in Group I and 59.92± 7.54 (48-76) in Group II. 14 male and 11 female were included in Group I and 16 male and 9 female were included in Group II. The mean duration of surgery for Group I was 50.0±12.58 (30-70) minutes, for Group II was 71.8±26.33 (45-135) minutes. Mean pain scores three minutes after the anesthesic procedure application, during the surgery, just at the end of the surgery and four hours after the surgical procedure were recorded. Mean values for Group I were respectively; 1.48±0.77 (0-3), 1.20±0.65 (0-3), 2.56±0.77 (1-4), 2.68±0.85 (1-4) and for Group II: 1.80±1.22 (0-5), 1.56±0.92 (0-4), 1.56±0.77 (0-3), 1.24±0.66 (0-3). Mean pain scores during the surgery and four hours after the surgical procedure were statistically higher for Group 1 than Group 2 (p<0.001).
Conclusion: With the use of sub-Tenon's anesthesia in vitreoretinal surgery, pain perception was diminished effectively in both two groups during the peroperative and postoperative periods. Despite a longer operative time, mean pain scores were significantly lower in Group II (prilocaine-bupivacaine) than Group I (prilocaine) in early and late postoperative periods (p<0.001). Keywords : Bupivacain, prilocain, sub-Tenon’s anesthesia, vitreoretinal surgery
