The needleless sub-tenon’s block is being increasingly used for vitreo retinal surgeries. The present study is to evaluate the safety and efficacy of “needleless” regional anaesthesia through the sub-tenon route for vitreo retinal surgery with Dexmedetomidine or Paracetamol infusion as sedation for Monitored Anaesthesia Care (MAC). Methods: Twenty eight patients were included and studied after ethics committee approval. These consented patients were in American Society of Anaesthesiologists physical status I-III of both sexes. They were given 0.75% Ropivacaine through sub-tenon route. Any complication such as intra-ocular pressure rise or orbital haemorrhage were noted. Twenty four hours after the surgery, the patients were asked to grade their pain during postoperative period and was noted on a 10 point visual analog scale. The need for any rescue analgesic was also noted. Patient’s demography, co-morbidities and previous vitreo-retinal surgeries performed were recorded. The haemodynamic stability, respiratory depression or any complication due to technique or medications were also recorded as secondary outcomes. Results: Desired sedation score of 2-3 was effectively achieved with intraoperative infusions of Dexmedetomidine (Group D) and Paracetamol (Group P). Seven patients had marginal hypotension and bradycardia in group D which did not require any active treatment. The duration of postoperative analgesia was significantly prolonged in group D compared with group P as assessed by visual analogue scale. Respiratory depression did not occur in any patient. No adverse events inherent to sedative medication or technique were observed in any patient. Conclusion: Needleless regional anaesthesia appears to be safe and effective and can thus be considered as an alternative to routine peribulbar block for vitreo- retinal cases. The clinical efficacy and safety of Dexmedetomidine was better than Paracetamol in terms of sedation and intraoperative haemodynamic stability without respiratory depression.