Local anesthesia with intravenous sedation for surgical repair of selected open globe injuries

Ingrid U. Scott, Cathleen M. Mccabe, Harry W Flynn, Dagmar R. Lemus, Joyce C. Schiffman, Dale S. Reynolds, Mauricio B. Pereira, Armando Belfort, Steven Gayer

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)707-711
Number of pages5
JournalAmerican Journal of Ophthalmology
Volume134
Issue number5
DOIs
StatePublished - Nov 1 2002

Fingerprint

Local Anesthesia
General Anesthesia
Wounds and Injuries
Visual Acuity
Surgical Wound Dehiscence
Pupil Disorders
Chi-Square Distribution
Foreign Bodies
Medical Records
Anesthesia

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Local anesthesia with intravenous sedation for surgical repair of selected open globe injuries. / Scott, Ingrid U.; Mccabe, Cathleen M.; Flynn, Harry W; Lemus, Dagmar R.; Schiffman, Joyce C.; Reynolds, Dale S.; Pereira, Mauricio B.; Belfort, Armando; Gayer, Steven.

In: American Journal of Ophthalmology, Vol. 134, No. 5, 01.11.2002, p. 707-711.

Research output: Contribution to journalArticle

Scott, Ingrid U. ; Mccabe, Cathleen M. ; Flynn, Harry W ; Lemus, Dagmar R. ; Schiffman, Joyce C. ; Reynolds, Dale S. ; Pereira, Mauricio B. ; Belfort, Armando ; Gayer, Steven. / Local anesthesia with intravenous sedation for surgical repair of selected open globe injuries. In: American Journal of Ophthalmology. 2002 ; Vol. 134, No. 5. pp. 707-711.
@article{44a99d4523f54e6ebb18985e8b645e71,
title = "Local anesthesia with intravenous sedation for surgical repair of selected open globe injuries",
abstract = "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.",
author = "Scott, {Ingrid U.} and Mccabe, {Cathleen M.} and Flynn, {Harry W} and Lemus, {Dagmar R.} and Schiffman, {Joyce C.} and Reynolds, {Dale S.} and Pereira, {Mauricio B.} and Armando Belfort and Steven Gayer",
year = "2002",
month = "11",
day = "1",
doi = "10.1016/S0002-9394(02)01692-6",
language = "English",
volume = "134",
pages = "707--711",
journal = "American Journal of Ophthalmology",
issn = "0002-9394",
publisher = "Elsevier USA",
number = "5",

}

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

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.

UR - http://www.scopus.com/inward/record.url?scp=0036845807&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036845807&partnerID=8YFLogxK

U2 - 10.1016/S0002-9394(02)01692-6

DO - 10.1016/S0002-9394(02)01692-6

M3 - Article

C2 - 12429247

AN - SCOPUS:0036845807

VL - 134

SP - 707

EP - 711

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

SN - 0002-9394

IS - 5

ER -