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Rats are commonly used as an animal model to study glaucoma, which is induced experimentally using invasive painful procedures. Peribulbar anesthesia (PBA) is frequently used in people and domestic animals prior to ophthalmic surgeries to provide excellent perioperative analgesia. The goal of this study was to develop a PBA technique adapted to rat anatomy, to improve welfare of animals used as a glaucoma model. Eighteen rat cadavers were used to establish the optimal injection technique and the volume of injectate required. Four injection techniques using lidocaine 2% and contrast agent (1:1 volume ratio) were compared using computed tomography (CT) imaging performed before and after injection. A board-certified radiologist, masked regarding the injection techniques used, reviewed all CT images and scored injectate distribution at 4 locations: extraconal, intraconal, around the optic nerve and at the orbital fissure (scale 0-8; 0=none, 8=excellent). Injectate distribution scoring (median; range) was significantly higher (i.e., better) using the dorso-medial (5; 2-6) and medial-canthus (4.5; 2-8) techniques compared with mid-ventral (3; 2-5) and ventro-lateral (2; 1-3) techniques. A volume of 0.1 mL/100 g body weight provided overall good distribution, while a volume of 0.2 mL/100 g produced excessive exophthalmos. Presence of intracranial contrast was observed following all technique. In conclusion, PBA using the dorso-medial or medial-canthus techniques are most likely to provide local anesthesia. The intracranial contrast observed could be the result of post-mortem vessel leakage. Results of this preliminary study will be used to assess the efficacy and safety of these techniques in experimental rats. [ABSTRACT FROM AUTHOR]

Objective: Retirement can be traumatic, and physicians are not immune. The Israeli Medical Association (IMA) has been conducting a preparatory course for retirement for its members reaching retirement. The objective of the present study was to survey the characteristics of participating physicians, to map their activities following retirement, to gauge their appreciation of the course, and to assess their willingness to continue their association with the IMA., Methods: Questionnaires were mailed to 210 attendees of the IMA course in 2000-2002, and responses were tabulated and analyzed., Results: The response rate was 33%--40 male and 30 female physicians, and 75% of them were still working at the time of response. They classified their quality-of-life as appropriate (70%), modest (2%), and unfitting (27%). Continued work was directly related to the preservation of fitting lifestyle (p < 0.0001), and of the 17 physicians not working only 4 defined their quality of living as suitable. Of the respondents, 83% were in good health, 50% needed medical attention, and 77% received proper care. The vast majority spent time with family and friends, reading, listening to music, going on trips and cultural events and engaged in sports; the minority spent time learning, busy with hobbies or volunteer work. Approximately half of the respondents attended continuing medical education classes. Much satisfaction was recorded for most activities, but television, friends, volunteer work or continuing education were only partly enjoyable. The IMA preparatory course was satisfactory according to 94% of the respondents, but many requested to broaden its scope. Over 92% wanted to maintain an "open-line" with the IMA, for obtaining information, counseling, and participation in social activities and continuing education. The majority was willing to volunteer in the IMA. No gender bias was found in most of the responses., Conclusion: This preliminary survey of physician retirement in Israel found that once physicians ceased working, many considered their life quality unfitting. The need to remain associated with the IMA is indicative of the large social and emotional importance of this membership.