TY - JOUR
T1 - Local anesthesia with intravenous sedation for surgical repair of selected open globe injuries
AU - Scott, Ingrid U.
AU - Mccabe, Cathleen M.
AU - Flynn, Harry W.
AU - Lemus, Dagmar R.
AU - Schiffman, Joyce C.
AU - Reynolds, Dale S.
AU - Pereira, Mauricio B.
AU - Belfort, Armando
AU - Gayer, Steven
N1 - Funding Information:
This study was supported in part by Research to Prevent Blindness, Inc., New York, New York.
PY - 2002/11/1
Y1 - 2002/11/1
N2 - PURPOSE: To report factors associated with the use of local anesthesia with intravenous sedation (local anesthesia/sedation) rather than general anesthesia for surgery for open globe injuries in adult reparable eyes. DESIGN: Retrospective, nonrandomized, comparative case series. METHODS: Medical records were reviewed of all patients with open globe injuries repaired at Bascom Palmer Eye Institute between 1995 and 1999. "Adult reparable eyes" (eyes in patients ≥18 years of age, not treated with primary enucleation or evisceration, followed up ≥2 months) were included. RESULTS: In all, 220 eyes of 218 patients met inclusion criteria. General anesthesia was employed in 80 of 200 (36%) and local anesthesia/sedation in 140 of 220 (64%). Patients who had local anesthesia/sedation were significantly more likely to have an intraocular foreign body (31% vs 14%; P = .010, chi-square test), better presenting visual acuity (1.8 logMAR [logarithm of the minimum angle of resolution] units vs 2.5 logMAR units; P < .001, t test), more anterior wound location (75% corneal/limbal vs 65%; P = .003, chi-square), shorter wound length (6.3mm vs 10.8mm; P < .001, t test), and dehiscence of previous surgical wound (26% vs 12%; P = .021, chi-square) and were significantly less likely to have an afferent pupillary defect (22% vs 51%; P < .001, chi-square). There was no anesthesia-related complication in either group. The local anesthesia/sedation group had a shorter mean operating time than did the general anesthesia group (78 minutes vs 117 minutes; P < .001, t test). The general anesthesia group had a longer mean follow-up than the local anesthesia/sedation group (20.2 months vs 13.9 months, respectively; P = .002, t test). Change in visual acuity between the presenting and final examinations was similar for open globe injuries repaired with general anesthesia compared with local anesthesia/sedation (0.94 vs 0.72 logMAR units of visual acuity, respectively; P = .16, t test). CONCLUSIONS: Local anesthesia/sedation is a reasonable alternative to general anesthesia for selected patients with open globe injuries.
AB - PURPOSE: To report factors associated with the use of local anesthesia with intravenous sedation (local anesthesia/sedation) rather than general anesthesia for surgery for open globe injuries in adult reparable eyes. DESIGN: Retrospective, nonrandomized, comparative case series. METHODS: Medical records were reviewed of all patients with open globe injuries repaired at Bascom Palmer Eye Institute between 1995 and 1999. "Adult reparable eyes" (eyes in patients ≥18 years of age, not treated with primary enucleation or evisceration, followed up ≥2 months) were included. RESULTS: In all, 220 eyes of 218 patients met inclusion criteria. General anesthesia was employed in 80 of 200 (36%) and local anesthesia/sedation in 140 of 220 (64%). Patients who had local anesthesia/sedation were significantly more likely to have an intraocular foreign body (31% vs 14%; P = .010, chi-square test), better presenting visual acuity (1.8 logMAR [logarithm of the minimum angle of resolution] units vs 2.5 logMAR units; P < .001, t test), more anterior wound location (75% corneal/limbal vs 65%; P = .003, chi-square), shorter wound length (6.3mm vs 10.8mm; P < .001, t test), and dehiscence of previous surgical wound (26% vs 12%; P = .021, chi-square) and were significantly less likely to have an afferent pupillary defect (22% vs 51%; P < .001, chi-square). There was no anesthesia-related complication in either group. The local anesthesia/sedation group had a shorter mean operating time than did the general anesthesia group (78 minutes vs 117 minutes; P < .001, t test). The general anesthesia group had a longer mean follow-up than the local anesthesia/sedation group (20.2 months vs 13.9 months, respectively; P = .002, t test). Change in visual acuity between the presenting and final examinations was similar for open globe injuries repaired with general anesthesia compared with local anesthesia/sedation (0.94 vs 0.72 logMAR units of visual acuity, respectively; P = .16, t test). CONCLUSIONS: Local anesthesia/sedation is a reasonable alternative to general anesthesia for selected patients with open globe injuries.
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U2 - 10.1016/S0002-9394(02)01692-6
DO - 10.1016/S0002-9394(02)01692-6
M3 - Article
C2 - 12429247
AN - SCOPUS:0036845807
SN - 0002-9394
VL - 134
SP - 707
EP - 711
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 5
ER -