The National Survey of Local Anaesthesia for Ocular Surgery. II. Safety profiles of local anaesthesia techniques

Abstract

Purpose: To describe the adverse events associated with local anaesthesia (LA) for intraocular surgery.

Methods: An observational study of practice of LA in the whole of the United Kingdom was conducted over 3 months in late 1996. Staff in all ophthalmology theatres in the National Health Service were invited to report every LA given for the purpose of intraocular surgery during the first week, and thereafter to report adverse events only.

Results: During the first week, the reported incidence of all adverse events within the orbit was 2.7%, and for 'systemic' adverse events it was 0.9%. Serious adverse events were reported in association with all LA techniques. In 3 months, 18 events were described as 'life-threatening' by respondents, and further patients were reported to have had epileptic fits or were transferred directly from the operating theatre to an intensive care unit. The voluntary nature of the survey introduces some bias from under-reporting, making the incidence of these severe events difficult to assess. Reported incidence of severe 'systemic' adverse events was similar for all LA techniques.

Conclusions: Serious adverse events were reported in association with with all LA techniques. This implies that we should be prepared for such events in all patients who have intraocular surgery.