[The combination of retrobulbar block with general anaesthesia may lead to pre-emptive analgesia in patients undergoing pars plana vitrectomy].

Subject: To determine whether additional regional blocking provides pre-emptive analgesia in patients undergoing elective pars plana vitrectomy.

Methods: In a prospectively randomised, double-blinded trial we investigated the potential benefit of combining regional anaesthesia (RA) with general anaesthesia (GA). In each group 25 patients undergoing pars plana vitrectomy were either done under GA (group A), GA combined with retrobulbar block (group B) or GA combined with peribulbar block (group C). Patients were examined by assessing NAS (numeric analogue scale).

Results: At all times, patients of group B experienced significantly less pain than patients in either group A or C (p < 0.001). There were no significant differences in pain scores between patients in groups A and C. Only 4 patients in group B required analgesics, whereas 17 patients in group A and 12 patients in group C.

Conclusion: Certain ophthalmic operations are likely to cause postoperative pain when performed under GA alone, whereas the combination of retrobulbar block with GA reduces the development of pain as pre-emptive analgesia.