Comparative Analysis Between Peribulbar Block and Subtenon Block in Manual Small Incision Cataract Surgery

Background: Ocular anaesthesia is an important starting step for every ophthalmic procedure.Many anaesthetic techniques are in vogue, each with its advantages and disadvantages.Two most commonly used ophthalmic anaesthetic methods are peribulbar block and subtenon block.Peribulbar block places anaesthetic mixture into peribulbar space via a sharp needle whereas subtenon block places anaesthetic mixture into subtenon space via a blunt cannula.Our study aspires to compare these two anaesthetic blocks in terms of efficacy and safety.Methods: This a randomised control study aimed to compare subtenon block versus peribulbar block in manual small incision cataract surgery.This study was done in Govt.Medical College, Anantnag & District Hospital Kupwara, Kashmir from August 2020 to August 2022.814 patients were recruited into study.A subjective pain scale was used to assess pain while as akinesia was evaluated by objective numerical grading.Results: Patients were divided into two groups: 407 in peribulbar (PB) group and 407 in subtenon (ST) group.The average score for pain during anaesthesia administration was 0.86 for the PB group and 0.29 for ST group.Mode for pain score in PB group was 1 and ST group was 0. Globe akinesia onset was faster in ST group (2.7 ± 1.2 minutes) as compared to PB group (7.1 ± 2.7 minutes).335 PB group and 301 patients in ST group had good akinesia.99 and 91 patients showed complications, especially subconjunctival hemorrhage, chemosis and lid edema, in peribulbar and subtenon group respectively. Conclusion:Subtenon block is a safe, economical, effective and patient-friendly technique of ocular anaesthesia.It does away with sharp needle induced pain and complications of peribulbar block.