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Shannath L. Merbs, MD, PhD; Michael P. Grant, MD, PhD; Nicholas T. Iliff, MD

Arch Ophthalmol. 2004;122:349-352.

Objective  To evaluate an indwelling orbital catheter, placed at enucleation, for repeatable delivery of local anesthetic on an outpatient basis.

Methods  A retrospective, noncomparative, case series medical record review was performed of patients undergoing enucleation and receiving an indwelling orbital pain-control catheter at surgery by us from January 1, 1998, through December 31, 2001. Medical records were reviewed for hospitalization status postoperatively. Medical records of those patients treated on an outpatient basis were reviewed for patient and family comments about ease of use of the pain-control catheter and the degree of pain control and for any complications associated with catheter use. The main outcome measures included documented patient and family comments and physician medical record notes about catheter use and complications.

Results  Of the 85 patients, 67 were treated on an outpatient basis. The other 18 patients required a postoperative hospital admission for unassociated medical problems. Of the 67 patients, 58 (87%) reported using the catheter at home at least once. Of these 58 patients, 10 reported mild discomfort with catheter use, but in no case did the patient discontinue catheter use because of discomfort. All patients using the catheter reported pain relief lasting from 1 to 4 hours. No postoperative complications associated with catheter placement were observed.

Conclusion  The orbital pain-control catheter allows a caregiver to easily and repeatedly deliver local anesthetic to the operative site following enucleation, resulting in effective postoperative analgesia while the patient recovers at home.

From the Oculoplastic Division, The Wilmer Eye Institute, and the Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Md. The authors have no relevant financial interest in this article.