Retinal and Infra-ocular Pathology
Conditions
Brief summary
Eye surgeries are traditionally performed under local anaesthesia with a peribulbar block. This is a blind technique where local anaesthetic is injected into the back of the eye to make the eye numb and motionless for surgery. This is a blind injection and can be associated with complications such as bleeding, rupture of eye globe, blindness, increasing the pressure of the eye etc. It also has a high failure rate resulting in need for additional injections, further exposing the patient to possible complications. The investigators propose to perform the peribulbar block with ultrasound to guide the block needle placement and injection. The investigators hypothesize that ultrasound guided peribulbar blocks would have higher success rate (less need for additional injections) and that the total amount of local anaesthetics used would be decreased.
Interventions
PROCEDURELocal Anaesthetic Injection
Local anaesthetic is injected into the eye.
PROCEDUREUltrasound-Guidance
Device: Ultrasound Machine Peribulbar block local anaesthetic is injected into the eye with ultrasound guidance.
Sponsors
Sunnybrook Health Sciences Centre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing vitrectomy surgery
Exclusion criteria
* Lack of informed consent * Coagulopathic disorder, anticoagulated with INR (international normalized ratio) \> 1.5 or platelet count less than 75 x 10\^9/L * Pathological myopia. Inability of patient to lie down for 2 hours for the operation -Local infection at site of needle entry
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Failure of peribulbar block | 10 minutes after block performed | Ocular Anaesthetic Scoring System (OASS) score of less than 10 will be considered inadequate for surgery and a block failure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of the block | 5 and 10 min after block performed | Quality of the block based on the OASS score will be classified as poor (0-3), average (4-9) and good (10-14). |
| Incidence of Supplemental Peribulbar injections | Operative day 0 | To determine incidence of additional peribulbar injections after failure of original block as determined preoperatively by the anaesthetist or intraoperatively by the surgeon. |
| Volume of Total Local Anaesthetic Used | Operative day 0 | The total volume of local anaesthetic used for peribulbar block preoperatively and intraoperatively. |
Countries
Canada
Outcome results
None listed