Safety and Efficacy of Atraumatic Peribulbar Block Versus the Traditional Peribulbar Needle Technique: A Randomized Controlled Clinical Trial

Abstract Background: The purpose of this study was to compare the safety and efficacy of an atraumatic cannula for peribulbar block versus the traditional needle-based peribulbar block in ophthalmic surgery. Materials and Methods: This randomized, single-blind, parallel-group, clinical trial enrolled 120 patients of both genders, with the American Society of Anesthesiologists I–III who were scheduled for ophthalmic surgery. Participants were randomized into two groups. In the atraumatic group, 60 patients underwent an atraumatic peribulbar block using a 20–22-gauge cannula with 25 mm length, while 60 participants in the traditional group underwent a traditional peribulbar block using a 25-gauge needle ¾ inch. In both groups, 5–10 mL of a local anesthetic mixture of 0.5% bupivacaine and 2% lignocaine in equal proportions, together with 90 IU of hyaluronidase, was administered. The primary outcomes were the safety of using an atraumatic cannula for peribulbar block with no incidence of perforation. The secondary outcomes included the efficacy of sensory and motor block, incidence of injections, intraoperative events, technique failure, axial length, and local and technical complications. Results: Both groups achieved comparable success in motor and sensory block. The injection frequency was significantly lower in the atraumatic group ( P < 0.001), while intraoperative events were significantly higher ( P = 0.042). Complications, including local and technical issues, were similar across groups. Conclusion: In ophthalmic surgery, atraumatic peribulbar block is a relatively effective and safe approach with adequate anesthesia and akinesia as traditional peribulbar block.