Evaluation of Medial Canthus Block Using Different Local Anesthetics in Vitreoretinal Surgery

Background: Posterior segment surgeries are satisfactorily performed using local anesthesia through peribulbar block. Injection of local anesthetic using a short and small (25 gauge) needle avoids many of the complications of larger gauge needle techniques.Methods: 136 patients randomly enrolled in the study; divided into 4 groups, 34 each, Group I: Bupivacaine 0.5% + Hyaluronidase 30IU; Group II: Lidocaine 2% + Bupivacaine 0.5% + Hyaluronidase 30 IU; Group III: Levobupivacaine 0.5% + Hyaluronidase 30IU; Group IV: Lidocaine 2% + Levobupivacaine 0.5% mixture + Hyaluronidase 30IU.Results: Patients in the four groups reported no difference of statistical value regarding the postoperative analgesia frequency. As regards patients and surgical satisfaction, insignificant differences were reported between the study groups. No statistical significance of the medial canthus single injection technique when compared to injections given in more than one site.Conclusion: A single medial canthus technique is a promising alternative to the usual double injection peribulbar block with fewer incidences of local and systemic complications.