What are the advantages and disadvantages of general anesthesia for scleral buckle repair?

What are the advantages and disadvantages of general anesthesia for scleral buckle repair?

There are a number of disadvantages of scleral buckle repair under regional anesthesia. In patients undergoing repeat procedures, surgical time may exceed 2 hours, predisposing the patient to muscle and ligament strain of the back while lying on the hard operating room table. Giant retinal tears require changing position from supine to prone which can be anxiety-provoking for some individuals. Severe traction required to approach the posterior retina can provoke the oculocardiac reflex and/or pain. A thin sclera in the operated eye or blindness in the other eye makes the con-sequences of unintentional globe perforation during retro-bulbar block unacceptable in many cases. For all of these reasons, general anesthesia may be preferred.

Although offering freedom from many of regional anes-thesia’s disadvantages, general anesthesia is associated with several of its own problems. Postoperative pain, nausea, retching, bucking, and coughing are all recognized conse-quences of general anesthesia that predispose individuals to increased intraocular pressure.