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Cochrane Database of Systematic Reviews

Sub‐Tenon's anaesthesia versus topical anaesthesia for cataract surgery

Overview of attention for article published in Cochrane database of systematic reviews, August 2015
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Title
Sub‐Tenon's anaesthesia versus topical anaesthesia for cataract surgery
Published in
Cochrane database of systematic reviews, August 2015
DOI 10.1002/14651858.cd006291.pub3
Pubmed ID
Authors

Joanne Guay, Karl Sales

Abstract

Local anaesthesia for cataract surgery can be provided by sub-Tenon's or topical anaesthesia. Both techniques offer possible advantages. This review, which originally was published in 2007 and was updated in 2014, was undertaken to compare these two anaesthetic techniques. Our objectives were to compare the effectiveness of topical anaesthesia (with or without intracameral local anaesthetic) versus sub-Tenon's anaesthesia in providing pain relief during cataract surgery. We reviewed pain during administration of anaesthesia, postoperative pain, surgical satisfaction with operating conditions and patient satisfaction with pain relief provided, and we looked at associated complications. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE (last search in November 2014) and the reference lists of published articles. We looked for conferences abstracts and trials in progress and placed no constraints on language or publication status. We included all randomized studies that compared sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery. We assessed trial quality and extracted data in the format allowing maximal data inclusion. We included eight studies in this updated review but could retain in the analysis only seven studies on 742 operated eyes of 617 participants. Two cross-over trials included 125 participants, and five parallel trials included 492 participants. These studies were published between 1997 and 2005. The mean age of participants varied from 71.5 years to 83.5 years. The female proportion of participants varied from 54% to 76%. Compared with sub-Tenon's anaesthesia, topical anaesthesia (with or without intracameral injection) for cataract surgery increases intraoperative pain but decreases postoperative pain at 24 hours. The amplitude of the effect (equivalent to 1.1 on a score from 0 to 10 for intraoperative pain, and to 0.2 on the same scale for postoperative pain at 24 hours), although statistically significant, was probably too small to be of clinical relevance. The quality of the evidence was rated as high for intraoperative pain and moderate for pain at 24 hours. We did find differences in pain during administration of local anaesthetic (low level of evidence), and indications that surgeon satisfaction (low level of evidence) and participant satisfaction (moderate level of evidence) were less with topical anaesthesia. There was not enough evidence to say that one technique would result in a higher or lower incidence of intraoperative complications compared with the other. Both topical anaesthesia and sub-Tenon's anaesthesia are accepted and safe methods of providing anaesthesia for cataract surgery. An acceptable degree of intraoperative discomfort has to be expected with either of these techniques. Randomized controlled trials on the effects of various strategies to prevent intraoperative pain during cataract surgery could prove useful.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 162 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Australia 1 <1%
Switzerland 1 <1%
Unknown 160 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 16 10%
Student > Master 16 10%
Student > Ph. D. Student 12 7%
Student > Bachelor 12 7%
Other 11 7%
Other 35 22%
Unknown 60 37%
Readers by discipline Count As %
Medicine and Dentistry 53 33%
Nursing and Health Professions 13 8%
Pharmacology, Toxicology and Pharmaceutical Science 4 2%
Computer Science 3 2%
Agricultural and Biological Sciences 2 1%
Other 19 12%
Unknown 68 42%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 December 2015.
All research outputs
#20,011,936
of 25,457,858 outputs
Outputs from Cochrane database of systematic reviews
#10,818
of 11,499 outputs
Outputs of similar age
#191,564
of 279,149 outputs
Outputs of similar age from Cochrane database of systematic reviews
#259
of 278 outputs
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