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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)
 
 
 

The subjective experience of early postoperative pain following retrobulbar anaesthesia for enucleation and primary orbital implant.

INTRODUCTION: We performed a prospective audit of the level of postoperative pain experienced by patients following enucleation with insertion of a primary orbital implant after preincisional regional retrobulbar anaesthesia using bupivacaine 0.75% with 1:100,000 adrenaline. MATERIALS AND METHODS: An 11-point numerical ranking box scale was used to measure the subjective experience of postoperative pain following enucleation with insertion of a primary orbital implant in 40 patients with uveal melanoma. Surgery was performed under general anaesthesia with a supplementary peroperative retrobulbar injection of bupivacaine 0.75%/adrenaline 1:100,000. Pain scores were measured for the first 8 hours following administration of the block. RESULTS: The sample included 19 female and 21 male patients with a mean age of 66.7 years (31-87). At four hours post block, 80% were still pain free with 17% experiencing only mild to moderate pain (BS-11 = 1-4). Thirty-four (85%), twenty-eight (70%) and twenty-seven (67%) patients remained pain free at 2, 3 and 4 hours, respectively with no additional analgesia. The remainder scored BS-11 of 1-4 in 92% of cases. Twenty percent required supplementary analgesia (paracetemol in 78% cases) by 5 hours and 57% by 8 hours. BS-11 at 8 hours were 0 in 50%, 1-4 in 22% and 5-10 in 10% of patients (17% asleep). No complications using this technique were recorded. DISCUSSION: Using a preincisional retrobulbar injection of bupivacaine with adrenaline, BS-11 pain scores remained low with no or minimal additional analgesia for up to 4 hours post surgery. In combination with oral analgesia, effective pain control was provided in most cases for up to 8 hours post block.[1]

References

  1. The subjective experience of early postoperative pain following retrobulbar anaesthesia for enucleation and primary orbital implant. Bowyer, J., Jones, A., Damato, B., Leach, A., Shankar, J., Tripathi, A. Orbit (Amsterdam, Netherlands) (2003) [Pubmed]
 
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