Single-Prick Infiltration Anesthesia for External Dacryocystorhinostomy

Abstract

Purpose: To determine the effectiveness, complications and patient acceptance of single-prick local anesthesia for external dacryocystorhinostomy (DCR). Methods: Data were prospectively collected from January 2004 to March 2006 on 463 patients undergoing external DCR operated by a single surgeon. All surgeries were performed under single-prick local infiltration anesthesia. Replies to the Verbal Rating Scale (VRS) were recorded to measure pain intraoperatively at various steps of the surgery. Patients were specifically asked about discomfort during the surgery and whether they would undergo surgery under the same anesthesia if needed for the other eye. Results: The mean operative duration was 15.50 minutes (range 14–18 minutes). There were 298 females and 165 males. The mean age was 46.5 years (range 17–81 years). The patients reported being comfortable during and immediately after surgery. The VRS was 3–4 (mild pain) for the degree of pain during bone removal and flaps formation. The VRS was 0–2 (no pain) during skin incision and wound closure. None of the patients required additional anesthesia during surgery. None of the patients complained of nausea or vomiting intraoperatively or in the immediate postoperative period. The majority of the patients preferred the same anesthetic technique for surgery in the other eye if required. Conclusions: Single-prick local infiltration anesthesia for external DCR is safe, effective and has good patient acceptance.

KEYWORDS:

• Local infiltration anesthesia
• single-prick anesthesia
• external dacryocystorhinostomy
• patient acceptance
• verbal rating scale
• nasolacrimal duct obstruction