الفهرس 
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Abstract
Ophthalmic regional anesthesia became the main standard plan for ophthalmic surgery and replaced general anesthesia in the majority of cases. The ophthalmic regional anesthesia took the upper hand in patients with comorbid diseases; it is accompanied with negligible effects on the hemodynamic profile and avoids other side effects such as respiratory depression postoperative nausea and vomiting. It also provides better postoperative analgesia.
There are different techniques of ophthalmic regional anesthesia according to the site were the needle is inserted and the local anesthetic is injected. In the past the RBA was the gold standard in which the local anesthetic is injected inside the extraocular muscles cone behind the globe which was highly effective but was accompanied by dangerous complications.
PBA then replaced the RBA for its higher safety profile in which the needle is introduced outside muscle cone away from the neurovascular vital structures and the globe, the local anesthetic is injected in the adipose tissue inside the orbit and diffuses inside the muscle cone by the compartment theory. It is less effective than RBA but more safe.
In the nineties the medial canthal needle based ESA developed and proved to be similar in efficacy as RBA. In the ESA short needle is introduced in the linea similunaris to reach the subtenon plane around the sclera where the local anesthetic is injected which block the ciliary nerves directly that give sensory supply to the globe and diffuse inside the sheath of the extraocular muscles causing their motor blockade.
In the current study, 60 patients were allocated in to two groups, 30 in each group and randomized (using computer generated program) in a single blinded model:
- group A: Medial episcleral anesthesia (ESA) technique
- group B: Peribulbar anesthesia (PBA) technique
The study compared the two groups according to the demographic data, vital data in the form of MAP, heart rate, respiratory rate, and SpO2. These parameters showed no statistical significance.
It also compared the 2 groups according to the motor akinesia score at different intervals of time, onset of acceptable akinesia score and numeric pain score which proved that ESA group had better results regarding these parameters with high statistical significance.
Also our study focused on the safety profile of both techniques and found that there were no major complications accompanying both techniques.