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- W2095534734 abstract "Sub-Tenon's block is arguably a safer alternative to either a retrobulbar or peribulbar block in anaesthesia for anterior segment ophthalmic surgery. It avoids blind insertion of a needle into the orbit and consequently results in a lower risk of globe perforation or retrobulbar haemorrhage. Some anaesthetists avoid the use of sub-Tenon's block as they feel the adequacy of anaesthesia provided is less reliable than that provided by peribulbar and retrobulbar blocks. In our experience optimal sub-Tenon's block results in anaesthesia comparative with that from other techniques. Complete akinesia can be achieved, which, although not mandatory to facilitate surgery by experienced ophthalmologists, may be of assistance to trainee surgeons. Optimal sub-Tenon's block also reduces blephrospasm postoperatively. We would like to describe a clinical sign which we have found to be a reliable indicator of optimal sub-Tenon's block. Our technique for sub-Tenon's block includes the use of lidocaine 2% with 1 : 200 000 epinephrine and 75 IU hyaluronidase. We have found that optimal sub-Tenon's blocks have consistently resulted in an area of periorbital skin pallor 2–5 min after the block is performed (Fig. 3). This pallor is most likely due to vasoconstriction resulting from the epinephrine in the solution injected. We have found that a complete periorbital ring of profound pallor is reliably associated with optimal anaesthesia and akinesis. A lack of complete periorbital pallor is invariably associated with inadequate anaesthesia and the necessity to supplement the sub-Tenon's block with peribulbar infiltration. Periorbital skin pallor after successful sub-Tenon's block. We feel that the presence of a complete ring of periorbital skin pallor (the ‘Ring of Confidence’) is a reliable indicator of optimal anaesthesia for anterior segment ophthalmic surgery." @default.
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- W2095534734 date "2006-04-01" @default.
- W2095534734 modified "2023-10-17" @default.
- W2095534734 title "The 'Ring of Confidence'- an indicator of optimal anaesthesia following sub-Tenon's block" @default.
- W2095534734 doi "https://doi.org/10.1111/j.1365-2044.2006.04602.x" @default.
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