A comparative study of clinical outcome following topical versus peribulbar anesthesia in phacoemulsification surgery

The objective of our study was to evaluate and compare clinical outcomes, patients and surgeon’s satisfaction following topical versus peribulbar anesthesia in phacoemulsification surgery. A hospital based Randomized Prospective interventional Comparative Study done between November 2017 to May 2019. A total of 200 patients included in the study, ocular examination, biometry were done. Patients were randomly distributed into group1 TA (topical anesthesia) and group 2 PA (Peribulbar anesthesia), they underwent phacoemulsification with intraocular lens implantation, postoperative visual outcome and inflammation on day1 and after 1 week, VAS (Visual Analogue scale) pain scale used to analyse patients comfort and pain postoperatively. The Statistical analysis was performed by STATA 11.2 (College Station TX USA). In our study 200 participated, it was found in PA group, 60.47 ± 11.86 yrs and in TA group 59.01 ± 11.29yrs as mean age, majority were male. PA group had few complications during anesthesia and in both groups majority had no intraoperative complications. Log Mar visual acuity postoperative day 1, PA group was 0.65±0.40 and in TA was 0.49±0.32, post operative visual recovery was better in TA group patients and had less pain and more comfortable than PA. Surgeon had difficulty more with TA group patients. It was found, postoperative visual recovery was faster and better in patients with topical group with less postoperative inflammation and complications. Topical anesthesia being a non invasive procedure can be considered better than peribulbar when compared in terms of patients comfort and postoperative recovery.

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Comparison of peribulbar anesthesia and topical anesthesia on outcome of phacoemulsification

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172456 ◽

2017 ◽

Vol 5 (6) ◽

pp. 2608 ◽

Cited By ~ 2

Author(s):

Rishi Mehta ◽

Sharda Punjabi ◽

Nutan Bedi ◽

Chandra Kant Nagar

Keyword(s):

Intraoperative Complications ◽

Visual Outcome ◽

Topical Anesthesia ◽

Satisfaction Score ◽

The Other ◽

Patients Satisfaction ◽

Peribulbar Anesthesia ◽

Group 2 ◽

A Prospective Study ◽

Group 1

Background: Due to advancement in phacoemulsification techniques, there has been growing shift from peribulbar anesthesia (PA) to topical anesthesia (TA). But dilemma exists regarding the supremacy of one over the other as both types have certain advantages and disadvantages.Methods: A prospective study was conducted. Patients were divided into two groups. Group-1 underwent PA while group-2 underwent TA. Satisfaction score of patients and surgeons and incidence of complications were noted. The data was analyzed.Results: Lowest patients’ satisfaction score among group-1 vs. group-2 was 160 (87.9%) vs.82 (45.81%). Highest surgeons satisfaction score among group-1 and group-2 was 74(40.65%) vs. 2(1.1%). Intraoperative complications among the group-1 and group-2 were 35 (19.2%) vs. 86(48.0%).Conclusions: While TA provides initial painless phase of surgical procedure, PA results in lesser intraoperative complications resulting in better visual outcome.

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Pulsed Compared to Thermal Radiofrequency to the Medial Calcaneal Nerve for Management of Chronic Refractory Plantar Fasciitis: A Prospective Comparative Study

January 2018 - Pain Physician ◽

10.36076/ppj/2016.19.e1181 ◽

2016 ◽

Vol 8;19 (8;11) ◽

pp. E1181-E1187

Author(s):

Dina H. el-Hammady

Keyword(s):

Comparative Study ◽

Plantar Fasciitis ◽

Rating Scale ◽

Invasive Procedure ◽

Pain Scale ◽

University Hospital ◽

Pulsed Radiofrequency ◽

Prospective Comparative Study ◽

Waking Up ◽

Effective Analgesia

Background: Radiofrequency (RF) treatment is a minimally invasive procedure that has been used for more than 3 decades in treating various chronic pain syndromes. Conventional (continuous) RF treatment occasionally results in worsening or even initiating a new type of pain. The use of pulsed radiofrequency (PRF), which has a non- or minimally neurodestructive neuromodulatory effect, serves as an alternative to conventional RF therapy in many medical situations. Objectives: To evaluate the effect of applying PRF for 6 minutes vs. thermal radiofrequency (TRF) for 90 seconds to the medial calcaneal nerve for treatment of chronic refractory plantar fasciitis pain. Study Design: Prospective comparative study. Setting: Pain, Orthopedic, and Rheumatology and Rehabilitation Clinics of Assiut University Hospital. Methods: Twenty patients with refractory chronic bilateral plantar fasciitis received PRF to the medial calcaneal nerve for 6 minutes for one heel and TRF to the same nerve on the other heel (as their own control) for 90 seconds. Numerical verbal rating scale (NVRS) at waking up from bed and after prolonged walking, and satisfaction score were used for assessment of studied patients at one, 3, 6, 12, and 24 weeks from the intervention. Results: All studied patients showed significant improvement in their pain scale after the intervention that lasted for 24 weeks; however, the PRF heels had significantly better pain scale and satisfaction scores at the first and third weeks assessments when compared to the TRF heels. Effective analgesia was achieved after one week or less after PRF compared to 3 weeks for the TRF (P < 0.001). Limitations: No randomization. Conclusions: PRF to the medial calcaneal nerve is a safe and effective method for treatment of chronic plantar fasciitis pain. The onset of effective analgesia can be achieved more rapidly with PRF compared to TRF on the same nerve. Further randomized trials are needed to confirm the therapeutic effect and optimizing the dose of RF needed. Key words: Pulsed radiofrequency, thermal radiofrequency, medial calcaneal nerve, plantar fasciitis, plantar aponeurosis, visual analogue scale

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Suprasellar meningiomas: the effect of tumor location on postoperative visual outcome

Journal of Neurosurgery ◽

10.3171/jns.1988.69.4.0523 ◽

1988 ◽

Vol 69 (4) ◽

pp. 523-528 ◽

Cited By ~ 120

Author(s):

Brian T. Andrews ◽

Charles B. Wilson

Keyword(s):

Visual Loss ◽

Visual Outcome ◽

Tumor Location ◽

Postoperative Recovery ◽

Optic Canal ◽

Visual Disability ◽

Content Type ◽

Tuberculum Sellae ◽

Diaphragma Sellae ◽

Planum Sphenoidale

✓ The authors reviewed 38 cases of suprasellar meningioma to determine the correlation between tumor site and postoperative visual outcome. Progressive visual loss, the most frequent initial complaint (94.7%), occurred over a mean of 24½ months, was most often unilateral (18 patients) or bilateral but asymmetrical (14 patients), and was severe (20/200 vision or worse) in 23 patients; 24 patients had visual field abnormalities. Computerized tomography or magnetic resonance studies clearly delineated the lesions but did not appear to permit earlier diagnosis. Eleven patients had tumors limited to the tuberculum sellae; the tumor extended from the tuberculum sellae onto the planum sphenoidale in nine patients, into one optic canal in eight, onto the diaphragma sellae in seven, and onto the medial sphenoid wing in three. Patients with tumors affecting the optic canal had severe unilateral visual loss more often than those with tumors at other sites. Tumors limited to the tuberculum sellae were most often completely resected; postoperative recovery of vision was also most frequent in patients with tumors at this site. Tumors involving the diaphragma sellae or the medial sphenoid wing were least often completely removed and most likely to be associated with postoperative visual deterioration. Overall, 42% of patients had improved vision postoperatively, 30% remained unchanged, and 28% were worse. After a mean follow-up period of 38 months, 24 patients are doing well, four have significant visual disability, and three are blind or doing poorly. Two patients died of causes unrelated to their tumor. Three patients have had tumor recurrence.

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A Comparative Study of Endoscopic Myringoplasty vs Conventional Myringoplasty

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1209 ◽

2015 ◽

Vol 7 (3) ◽

pp. 132-137 ◽

Cited By ~ 5

Author(s):

Manish Kumar ◽

SK Kanaujia ◽

Ashutosh Singh

Keyword(s):

Comparative Study ◽

Surgical Outcome ◽

Healing Rate ◽

Postoperative Recovery ◽

Conventional Group ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Endoscopic Myringoplasty ◽

Conventional Myringoplasty ◽

Endoscopic Group

ABSTRACT Objective To evaluate the efficacy of endoscopic myringoplasty and comparison with conventional myringoplasty. Materials and methods Sixty cases of clinically diagnosed chronic suppurative otitis media with dry central perforation were taken into account of which 30 cases were undergone endoscopic myringoplasty and 30 cases undergone conventional myringoplasty. All patients were followed up on 3rd, 7th, 15th day, 6th weeks, 3rd and 6th months after surgery. Results The tympanic membrane's perforation healing rate was 86% (26/30), in conventional group of myringoplasty and 83% (25/30) in endoscopic group of myringoplasty and average hearing gain in conventional group was 13.96 dB and in endoscopic group was 15.03 dB. Conclusion The surgical outcome of endoscope assisted myringoplasty in terms of graft uptake and hearing improvement was comparable to the conventional microscope assisted myringoplasty, but in terms of cosmesis and postoperative recovery patients in the endoscope group had better results. How to cite this article Kumar M, Kanaujia SK, Singh A. A Comparative Study of Endoscopic Myringoplasty vs Conventional Myringoplasty. Int J Otorhinolaryngol Clin 2015;7(3): 132-137.

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