To assess the effect of peribulbar anesthesia on retinal microvasculature in primary open-angle glaucoma (POAG) patients undergoing cataract surgery using OCT Angiography. Participants: Forty-nine patients undergoing cataract surgery were divided into two groups. Group I included patients with no history of glaucoma, while group II included patients previously diagnosed as POAG with controlled IOP. Each participant received 6 mL of peribulbar anesthetic injection of 4 mL lidocaine 2% containing 150 IU hyaluronidase and 2 mL bupivacaine 0.5%. They were scanned with the OCT-A 10 minutes before and 10 minutes after injection for foveal deep (DCP), superficial (SCP) capillary plexuses density and total vessel density, foveal avascular zone (FAZ) diameter, optic disc total vessel density, and radial peripapillary capillary (RPC) network density. In addition, IOP was checked before and 10 minutes after injection. Results: Median percent change in DCP post-injection was significantly greater in group II (−43%) than in group I (−2.5%) (P < 0.001). Also, DCP total density median percent change post-injection was significantly higher in group II (−21%) than in group I (−0.9%) (P < 0.001). Foveal SCP vessel density and total vessel density median percent change post-injection were −62.6% and −16.2%, respectively, in group II and were −2.6% and −1.1%, respectively, in group I, which are statistically significant (P < 0.001). The FAZ diameter median percentage change postinjection was higher in group II (40.6%) than in group I (2.5%) (P < 0.001). Optic disc total vessel density and radial peripapillary capillary (RPC) network density post-injection median percent change were significantly higher in group II (−13.6%) and (−13.1%) respectively than in group I (−1.1%) and (−1.25%) respectively (P < 0.001). Conclusion: Peribulbar anesthesia harbors a deleterious ischemic effect on the retinal vascular tree of glaucoma patients, which could harmfully affect the vision and the visual field in those vulnerable patients.

Background: Ultrasound-guided blocks of the transversus abdominis plane (TAP) can be used for following surgery pain relief during abdominal surgeries and caesarean sections (CS) as well. Aim of study: Our goal was to study the difference in the efficiency of ultrasound-guided unilateral and bilateral TAP blocks as a postoperative analgesia for CS. Patients and Methods: In a randomized study, 100 pregnant women undergoing elective CS were split into 3 groups: Group I (the control group), no TAP blocks were administered, group II, 40 ml of bupivacaine 0.25% (100 mg) was administered to the RT side only and group III, 20 ml of bupivacaine 0.25% (50 mg) was administered to both sides. Results: No discernible distinctions could be found between groups II and III regarding postoperative visual analogue scale (VAS), post-anesthetic care unit time and the total amount of opioid consumption (P > 0.05). But, a substantial distinction existed between the control group and the other two groups in postoperative VAS, post-anesthetic care unit time and the total amount of opioid consumption Conclusion: With ultrasound-guided TAP blocks, efficient postoperative pain relief in CS may be obtained, however there was no variations between unilateral and bilateral TAP blocks in this regard.