Retinal Surgery With or Without Anesthesiologist, Comparison of Surgeon and Patient's Comfort

Study Overview
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Brief Summary
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Retinal surgeries are now performed in some hospitals with sub-Tenon anesthesia to replace conventional peribulbar anesthesia. The advantages of performing the surgery with Tenonian anesthesia can be: the cost reduced due to the non-intervention of an anesthesiologist, no pre-operative anesthetic consultation, no waiting period for the effectiveness of the peribulbar anesthesia (15-20min to have the effect of anesthesia of the eye). In addition, there are more numerous and dangerous complications of peribulbar anesthesia than sub-Tenonian anesthesia, however it allows the eye to remain stationary and to perform precise surgery safely, as long as the patient does not move his head. Performing a sub-Tenonian anesthesia also makes it possible to carry out surgeries more quickly, this method having an immediate effect and being performed by the surgeon, without the intervention of an anesthesiologist. The edema effect under the post / conjunctiva swells the area around the eye and allows partial oculomotor limitation. Finally, for the patient, recovery is faster: no sedation or venous route. To date, however, no study has proven that the surgeon can safely operate on the patient without increased complications compared to peribulbar anesthesia. This study aims to show that simple sub-Tenonian anesthesia in a short outpatient circuit does not induce more pain or discomfort for the patient than a longer outpatient circuit with bed and anesthesiologist. No studies have been performed on purely local anesthesia without a venous route. For this, patients operated on at the Foch hospital without an anesthesiologist under subtenon's anesthesia will be compared to patients operated on under peribulbar anesthesia with an anesthesiologist at the Pierre Cherest clinic.

Official Title
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Retinal Surgery With or Without Anesthesiologist, Comparison of Surgeon and Patient's Comfort

Conditions
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Retinal Disease

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients over 18 years old Patients with an indication for retinal surgery Not having opposed to participate in the study Exclusion Criteria: Claustrophobia Unbalanced psychiatric pathology Inability to lie down Deprived of liberty or under guardianship.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Tenonian surgery<br>Hospital recruitment with outpatient surgery without the presence of an anesthesiologist, without loco-regional anesthesia and without intravenous route | |
| Peribulbar surgery<br>Gold standard: City recruitment with outpatient surgery with the presence of an anesthesiologist and with loco-regional anesthesia | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of the comfort and safety of the surgeon between patients operated with peribulbar or tenonian anesthesia | Number of eye or head movements of the patient during the operation | At the surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of the patient's comfort during the operation between the 2 groups | Postoperative Iowa Satisfaction with Anesthesia Scale (ISAS) Score rated from 11 (worse outcome) to 66 (better outcome) | 15 minutes after the end of the surgery | 
| Comparison of the patient's comfort during the operation between the 2 groups regarding pain | Visual analogic scale (VAS) of pain during the surgery rated from 0 No pain to 10 worst possible pain | Preoperative, peroperative and 15 minutes post surgery | 
| Comparison of operating time between the 2 groups | Operating time | At the end of the surgery | 
| Assessement of the security between the 2 groups | Intraoperative complications and peroperative events | At the end of the surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Peribulbar surgery, Tenonian surgery, Retinal surgery, Surgeon comfort, Patient comfort