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Severe adverse events associated with local anaesthesia in cataract surgery: 1 year national survey of practice and complications in the UK.

Authors :
Lee, Richard M. H.
Thompson, John R.
Eke, Tom
Source :
British Journal of Ophthalmology; Jun2016, Vol. 100 Issue 6, p772-776, 5p, 2 Charts, 2 Graphs
Publication Year :
2016

Abstract

Background Recent years have seen a major change in practice of local anaesthesia (LA) for cataract surgery. Aims (1) To estimate current usage of LA techniques for cataract surgery, (2) to estimate the incidence of severe adverse events associated with each LA technique, (3) to compare with our previous 2003 study. Methods This was a prospective, observational study of routine practice. For 13 months in 2012–2013, the British Ophthalmological Surveillance Unit sent monthly mailings to all senior British ophthalmologists, asking for reports of 'potentially sight-threatening or lifethreatening complications of LA for cataract surgery'. Current practice was assessed by questionnaire. Results Cataract surgery comprised 3.4% general anaesthesia, 92.5% LA alone and 4.1% LA with sedation. Techniques for the estimated 357 000 LA cataracts were: 8.8% peribulbar, 1.3% retrobulbar, 50.5% sub-Tenon's, 1.4% subconjunctival, 13.8% topical, 24.2% topical-intracameral LA. Severe sight-threatening complications included seven globe perforations, one cilioretinal artery occlusion and one severe corneal oedema. Severe life-threatening complications included one profound vasovagal episode, one silent myocardial infarction, one anaphylactic reaction and one supraventricular tachycardia. Underreporting means that more complications probably occurred. Conclusions There has been a large swing towards 'non-injection' LA in recent years. Serious adverse events were reported with all techniques except topical-intracameral and subconjunctival LA, though the incidence appears lower for 'non-injection' LA. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00071161
Volume :
100
Issue :
6
Database :
Complementary Index
Journal :
British Journal of Ophthalmology
Publication Type :
Academic Journal
Accession number :
115757734
Full Text :
https://doi.org/10.1136/bjophthalmol-2015-307060