Estudo comparativo entre agulhas de 25x0,70mm ou 20x0,55mm para anestesia retrobulbar com baixo volume anestésico em tratamento de catarata por facoemulsificação

Abstract

To compare quality and safety of retrobulbar anesthesia (RBA) for phacoemulsification using needles of two different sizes: 25x0.7mm or 20x 0.55mm. Methods: This is a prospective, comparative study with patients undergoing cataract surgery with phacoemulsification. After support measures and sedation, all patients were submitted to retrobulbar anesthesia with a single inferior-lateral punction with 4ml of ropivacaína 1% with hyaluronidase- 50 U/ml. The patients were randomized to group I (GI), with a 25x0.7mm needle, or group II (GII), with a 20x0.55mm needle. In one pacient in each group, a computorized tomography was done during the ARB, and five minutes atfter the anesthetic solution injection. The quality of the procedure was obtained measuring ocular motility at three, five and ten minutes after the RBA. The incidence of adverse events was observed. The surgeon’s and patient’s satisfaction was measured with a standard questionnaire. Results – Fifty-four patients were included (27 in each group). No patient in either group complained pain, proprioception or light perception during the surgery. The surgeons considered the quality of the anesthesia very good or excellent in 96%, and the patients in 100% in both groups. There was no statistically difference comparing the need of multiple punctures between the groups. There was less ocular motility in GI at 3 minutes (0.6±1.1 vs 1.3±1.4, p=0.03). There was no statistically difference in ocular motility at 5 minutes. The needle tip was displaced in the intraconal space in both groups. No adverse event was related in the study. Conclusion- The RBA with 20x5.5mm with low volume of anesthetic is a safe and effective option for anesthesia in phacoemulsification surgery