Posters

Comparison of peribulbar vs topical anaesthesia for cataract surgery in patients with underlying cardiovascular disease

Poster Details

First Author: A.Kothari INDIA

Co Author(s):    G. Behera   A. Subramanian   S. Rene   T. Subramanyan           

Abstract Details

Purpose:

An observational comparative study between topical and peribulbar anaesthesia for hemodynamic changes, rate of complications and degree of patient satisfaction in patients with cardiovascular disease undergoing routine cataract surgery.

Setting:

Tertiary care hospital in South India.

Methods:

Patients above 40 years with hypertension and other cardiovascular diseases, treated/controlled, were scheduled for cataract surgery. The patients were asked to choose between topical anaesthesia and peribulbar block; 75 patients in each group were included. Heart rate, blood pressure (BP), ophthalmic and systemic complications were noted: preoperatively, immediately after block, intra-operatively, immediate post-operatively and 1 hour post-operatively. In addition, pain scores [Visual Analogue Scale (VAS)] were also recorded 1 hour after the surgery.

Results:

Patients in topical group(58.91±8.17yr) were significantly younger than peribulbar(64.83±8.15yr), p<0.001. All patients suffered from hypertension (controlled) and 10/75 in peribulbar, 4/75 in topical group from coronary artery disease. Diabetes mellitus was present in 41.33%-peribulbar and 34.67%-topical group. There was statistically significant rise in pulse rate and BP after peribulbar injection and intraoperatively, that gradually reduced to baseline 1hour after surgery in both groups(p<0.001), with systolic BP intra-operatively being significantly greater in peribulbar group (peribulbar: 155.49±18.14mmHg, topical:147.95±17.71mmHg; p~0.01). No adverse events were reported. We found that topical group(1.12±0.99) had slightly lower VAS scores compared to peribulbar(1.44±0.90), p~0.04.

Conclusions:

Cataract surgery appears to be reasonably safe and uncomplicated in all groups of patients with cardiovascular disease. There is slight rise of heart rate and blood pressure immediately after giving injection of peribulbar anaesthesia probably due to injection related anxiety and pain. With regards to pain perception, patient satisfaction with topical and peribulbar anaesthesia were comparable. Therefore, in uncomplicated cataract surgery, where patient is consenting, topical anaesthesia may be preferable due to non-invasiveness, adequate analgesia and minimal effect on haemodynamic parameters.

Financial Disclosure:

None