Abstract

Research Article

The impact of two different doses of Dexmedetomidine to Local Anesthetic Mixture on the quality of single injection Peribulbar Block in Vitreoretinal operations

Nagat S EL-Shmaa*, Ramadan Salama and Mohamed El-Kashlan

Published: 30 January, 2018 | Volume 2 - Issue 1 | Pages: 001-008

Objective: To evaluate the impact of adding two different doses of dexmedetomidine to local anesthetic mixture on the quality of single injection peribulbar block in vitreoretinal operations

Design: A prospective, double-blinded and randomized study.

Setting: carried out in operating room of our university hospital.

Patients: The study included 120 patients with viteroretinal diseases who were scheduled for vitreoretinal operations during the period from April 2016 to March 2017.

Interventions: 120 patients were randomly allocated to three groups of 40 patients each. Group I (the control group) received 5-7 ml mixture of lidocaine 2% and Levobupivacaine 0.5% with 120 IU of hyaluronidase, group II received5- 7 ml mixture of lidocaine 2% and Levobupivacaine 0.5% with 120 IU of hyaluronidase +15 µgdexmedetomidine, and group III received5- 7 ml mixture of lidocaine 2% and Levobupivacaine 0.5% with 120 IU of hyaluronidase + 30 µg dexmedetomidine

Measurements: The primary outcome was to evaluate the impact of adding two different doses of dexmedetomidine on the onset of globe anesthesia and akinesia. Secondary outcomes were the duration of globe anesthesia and akinesia, overall patient satisfaction and surgeon satisfaction.

Results: The onset of globe anesthesia was significantly shorter in group II and III in comparison with group I. Adding dexmedetomidine to the local anesthetic mixture prolonged the duration of globe analgesia, and this difference was statistically significant in group II and III in comparison with the group I.

Conclusion: Adding dexmedetomidine to a mixture of lidocaine 2% and levobupivacaine/hyaluronidase mixture in single injection peribulbar block shortened sensory and motor block onset, extended the analgesia period and the motor block duration with high patient and surgeon satisfaction.

Read Full Article HTML DOI: 10.29328/journal.ijcar.1001005 Cite this Article Read Full Article PDF

Keywords:

Dexmedetomidine; Single injection peribulbar block; Vitreoretinal operations

References

  1. Chishti K, Varvinskiy A. Anaesthesia for ophthalmic surgery. ATOTW. 2009; 135: 1-11.
  2. Godarzi M, Beyranvand S, Arbabi S, Sharoughi M, Mohtaram R, et al. Comparing the effect of using atracurium and cisatracurium as adjuvant agents to the local anesthetic substance on peribulbar-induced akinesia. Acta Med Iran. 2011; 49: 509-512.
  3. Loots JH, Koorts AS, Venter JA. Peribulbar anesthesia. A prospective statistical analysis of the efficacy and predictability of bupivacaine and a lignocaine bupivacaine mixture. J Cataract Surg. 1993; 19: 72-76. Ref.: https://goo.gl/ZtpSnq
  4. Zahl K, Jordan A, Mc Groarty J, Gotta AW. PH-adjusted bupivacaine and hyaluronidase for peribulbar block. Anesthesiology. 1990; 72: 230-232. Ref.: https://goo.gl/KvW8nv
  5. Baharti N, Madan R, Kaul HL, Khokhar SK, Mishra S. Effect of addition of clonidine to local anesthetic mixture for peribulbar block. Anesth Intensive Care. 2002; 30: 438-441. Ref.: https://goo.gl/6dc5Bp
  6. Sinha R, Sharma A, Ray BR, Chandiran R, Chandarlekha C. Effect of addition of magnesium to local anesthetics for peribulbar block: a prospective randomized double-blind study. Saudi J Anesthesia. 2016; 10: 64-67. Ref.: https://goo.gl/yK8qcx
  7. Reah G, Bodenham AR, Braithwaite P, Esmond J, Menage MJ. Peribulbar anesthesia using a mixture of local anaesthetic and vecuronium. Anaesthesia. 1998; 53: 551-554. Ref.: https://goo.gl/V9hS7e
  8. Gandhi RR, Shah AA, Patel I. Use of dexmedetomidine along with bupivacaine for brachial plexus block. Natl J Med Res. 2012; 2: 67-69. Ref.: https://goo.gl/wRBnHi
  9. Rizzo L, Marini M, Rosati C, Calamai I, Nesi M, et al. Peribulbar anesthesia: a percutaneous single injection technique with a small volume of anesthetic. Anesthesia & Analgesia. 2005; 100: 94-96. Ref.: https://goo.gl/ktEZ3p
  10. Abdelhamid AM, Mahmoud AAA, Abdelhaq MM, Yasin HM, Bayoumi ASM. Dexmedetomidine as an additive to local anesthetics compared with intravenous dexmedetomidine in peribulbar block for cataract surgery. Saudi Anesthesia. 2016; 10: 50-54. Ref.: https://goo.gl/FbVmKP
  11. Sarvela PJ. Comparison of regional ophthalmic anesthesia produced by pH adjusted 0.75% and 0.5% bupivacaine and 1% and 1.5% etidocaine, all with hyaluronidase. Anesthesia & Analgesia. 1993; 77: 131-134. Ref.: https://goo.gl/PVd2d6
  12. Ringland R, Early S. Conscious sedation: documenting the procedure. J Emerg Nurs. 1997; 23: 611-617. Ref.: https://goo.gl/tNoQhR
  13. Wang F, Shen X, Guo X, Peng Y, Gu X, et al. Epidural analgesia in the latent phase of labor and the risk of cesarean delivery: a five-year randomized controlled trial. Anesthesiology. 2009; 111: 871-880. Ref.: http://bit.ly/2WIDYIg
  14. EL-Shmaa NS, El-Baradey GF. The Efficacy of Etomidate-Fentanyl versus Dexmedetomidine-Ketamine for Procedural Sedation and Analgesia during Upper Endoscopy and Biopsy: A Prospective, Randomized Study. J Anesth Clin Res. 2014; 5: 1-5. Ref.: http://bit.ly/2KfvVw0
  15. Hall JE, Uhrich TD, Barney JA, Arian SR, Ebert TJ. Sedation, amnesic and analgesic properties of small dose dexmedetomidine infusion. Anesthesia & Analgesia. 2000; 90: 699-705. Ref.: https://goo.gl/oDynE6
  16. Channabasappa SM, Shetty VR, Dharmappa SK, Sarma J. Efficacy and safety of dexmedetomidine as an additive to local anesthetics in peribulbr block for cataract surgery. Anesth Essays Res. 2013; 7: 39-43. Ref.: http://bit.ly/2KOmYZR
  17. Hafez M, Fahim MR, Abdelhamid MH, Youssef MMI, Salem AS. The effect of adding dexmedetomidine to local anesthetic mixture for peribulbar block in vitreoretinal surgeries. Egyptian J Anesthesia. 2016; 32: 573-579. Ref.: https://goo.gl/iJXAU3
  18. El-Ozairy Hala S, Tharwat AI. Comparative study of the effect of adding two different doses of dexmedetomidine to levobupivacaine/hyaluronidase mixture on the peribulbar block in vitreoretinal surgery. Ain-Shams J Anesthesiol. 2014; 7: 393-399. Ref.: https://goo.gl/5FhgqP
  19. Eisenach JC, De Kock M, Klimscha W. Alpha (2)-adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984-1995). Anesthesiology. 1996; 85: 655-674.
  20. Guo TZ, Jiang JY, Buttermann AE, Maze M. Dexmedetomidine injection into the locus ceruleus produces antinociception. Anesthesiology. 1996; 84: 873-881.
  21. Connelly NR, Camerlenghi G, Bilodeau M, Hall S, Reuben SS, et al. Use of clonidine as a component of the peribulbar block in patients undergoing cataract surgery. Regional Anesthesia and Pain Medicine. 1999; 24: 426-429. Ref.: https://goo.gl/tpFJPT
  22. Madan R, Bharti N, Shende D, Khokhar SK, Kaul HL. A dose response study of clonidine with local anesthetic mixture for peribulbar block: a comparison of three doses. Anesthesia & Analgesia. 2001; 93: 1593-1597. Ref.: https://goo.gl/dyqhoS
  23. Bahy-Eldeen HM, Faheem MR, Sameer D, Shouman A. Use of clonidine in peribulbar block in patients undergoing cataract surgery. Aust J Basic Appl Sci. 2011; 5: 247-250. Ref.: http://bit.ly/2KMoJXv

Figures:

Figure 1

Figure 1

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?