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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.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 82 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 1%
Switzerland 1 1%
Australia 1 1%
Unknown 79 96%

Demographic breakdown

Readers by professional status Count As %
Unspecified 12 15%
Researcher 12 15%
Student > Master 10 12%
Other 10 12%
Student > Bachelor 9 11%
Other 29 35%
Readers by discipline Count As %
Medicine and Dentistry 40 49%
Unspecified 18 22%
Nursing and Health Professions 7 9%
Pharmacology, Toxicology and Pharmaceutical Science 4 5%
Agricultural and Biological Sciences 3 4%
Other 10 12%

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
#9,618,923
of 12,527,219 outputs
Outputs from Cochrane database of systematic reviews
#8,597
of 8,923 outputs
Outputs of similar age
#149,885
of 238,523 outputs
Outputs of similar age from Cochrane database of systematic reviews
#246
of 264 outputs
Altmetric has tracked 12,527,219 research outputs across all sources so far. This one is in the 19th percentile – i.e., 19% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,923 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.2. This one is in the 10th percentile – i.e., 10% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 238,523 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 264 others from the same source and published within six weeks on either side of this one. This one is in the 6th percentile – i.e., 6% of its contemporaries scored the same or lower than it.