Subtenon’s Anesthesia

Synonyms

Episcleral anesthesia

Definition

Percutaneous application of anesthetics into the subtenon space between the globe and tendon capsule.

Epidemiology

Subtenon’s anethesia (STA) is mainly used as an alternative to retrobulbar anethesia in less invasive ocular surgery. Usually it causes anesthesia but ineffective motorblock. Some surgeons use STA before intravitreal injection. It is also used in cataract surgery.

History

Subtenon’s anesthesia has been used for a long time.

Clinical Features

STA does usually not produce sufficient motorblock. Therefore, the advantages over topical anesthesia are mainly the full anesthesia of the whole globe (Davison et al. 2007). For STA, there is mainly two techniques (Nouvellon et al. 2010). The first technique is the blunt technique, in which a small conjunctival incision is performed creating a conjunctival “button hole.” Thereafter, anesthetic is delivered into the subtenon space using a blunt needle. The second technique is performed using a...