Anaesthesia complication rates

Anaesthesia administered by sharp needles carries a greater risk of serious complications than subtenons cannula administration, according to a study published online ahead of print in Eye.

Rob L. Johnston of Gloucestershire Eye Department, Cheltenham General Hospital, UK and colleagues evaluated the Cataract National Dataset, which contains electronically recorded patient data gathered from 12 UK National Health Service Trusts.

An ophthalmologist administered anaesthetic in 56.7% of the 55 567 operations performed; anaesthetic was administered by an anaesthetist for 42.1% of operations, and by an assistant in 0.3% of the cases (personnel administering anaesthesia in the remaining 0.9% was unrecorded).

Across all Trusts, local anaesthesia was used in 95.5% of cases; topical anaesthesia, 22.3%; topical and intracameral, 4.7%; subtenons, 46.9%; peribulbar, 19.5%; retrobulbar, 0.5%. Minor complications (≥1) associated with sharp needle or subtenons cannula administration occurred in 4.3% of cases, with subtenons administration being 2.3 times more likely than sharp needles to cause minor complications. Serious complications associated with sharp needle or subtenons cannula administration occurred in 0.066% of cases (n=25), with sharp needle administration being 2.5 times more likely than subtenons to cause serious complications.

The team noted that, although subtenons administration of anaesthesia was associated with a greater risk of minor complications, sharp needles were more likely to produce serious complications.