Estudo comparativo entre agulhas de 25 × 0,70 mm ou 20 × 0,55 mm para anestesia retrobulbar com baixo volume anestésico em tratamento de catarata por facoemulsificação
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2008-12
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BACKGROUND AND OBJECTIVES: The objective of this study was to
compare the quality and safety of retrobulbar block for the treatment
of cataracts by phacoemulsification using needles of different sizes:
27 × 0.70 mm and 20 × 0.55 mm.
METHODS: Candidates for ophthalmic block for the treatment of
cataracts by phacoemulsification were selected prospectively. After
sedation and standardized monitoring, a retrobulbar block with 4 mL
of 1% ropivacaine containing hyaluronidase was performed with a
single inferolateral puncture. In Group I (GI), the 25 × 0.70 mm needle
was used, while in Group II (GII) a 20 × 0.55 mm needle was used. All
patients had a CT scan at the time of the blockade and five minutes
after the administration of the anesthetic solution with radiologic
contrast. Ocular mobility was assessed after three, five, and ten
minutes. The incidence of complications in both groups and the
satisfaction of patients and surgeons were compared by applying a
standardized questionnaire.
RESULTS: Fifty-four adult patients were evaluated (27 per group).
Patients did not complain of intraoperative pain or perception of light.
The anesthetic procedure was considered very good (VG) or excellent
(E) in 96.3% of the cases in both groups. All patients were subjected
to the same assessment. The need of block repetition between both
groups did not differ (p = 1.0). Patients in GI showed decreased ocu-
lar mobility at 3 minutes (p = 0.03). The intraconal retrobulbar placement
of the needle was observed on both groups. Anesthetic dispersion at
5 minutes was similar in the two groups.
CONCLUSIONS: Retrobulbar block with a single inferolateral puncture
with a 20 × 0.55 mm needle, using low doses of anesthetics, is an
effective and safe option for the treatment of cataracts by phacoemul-
sification.
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Palavras-chave
Cirurgia, oftálmica: catarata, facoemulsificação, Técnicas anestésicas, regional: bloqueio retrobulbar., Surgery, ophthalmologic: cataracts, phacoemulsification, Technique, regional: retrobulbar block
Citação
CARNEIRO, Haroldo Maciel; TEIXEIRA, Kim Irsen Santos; ÁVILA, Marcos Pereira de; ALVES NETO, Onofre; HANNOUCHE, Rosanna Zacharias; MAGACHO, Leopoldo. Estudo comparativo entre agulhas de 25 × 0,70 mm ou 20 × 0,55 mm para anestesia retrobulbar com baixo volume anestésico em tratamento de catarata por facoemulsificação. Revista Brasileira de Anestesiologia, Rio de Janeiro, v. 58, n. 6, p. 569-581, 2008.