Efficacy and safety of dexmedetomidine as an additive to local anesthetics in peribulbar block for cataract surgery

Channabasappa, Shivakumar M; Shetty, Vijaya R; Dharmappa, S; Sarma, Jahanabi

doi:10.4103/0259-1162.113987

Cited by 35 publications

(43 citation statements)

References 14 publications

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“…This study agrees with the results of Channabasappa et al [16], who examined two doses of dexmedetomidine as additive to admixture of lidocaine and bupivacaine in peribulbar anesthesia and they found that administration of dexmedetomidine accelerated the onset of the peribulbar anesthesia, prolonged its duration, and duration of postoperative analgesia. Moreover, they found that the dose of 50 μg dexmedetomidine produced sedation which made the patient more cooperative.…”

Section: Discussionsupporting

confidence: 82%

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

Elshmaa¹,

Elkashlan²,

Salama³

2018

Int J Clin Anesth Res

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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 signifi cantly 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 signifi cant in group II and III in comparison with the group I .Conclusions: 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.

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Section: Discussionsupporting

confidence: 82%

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

Elshmaa¹,

Elkashlan²,

Salama³

2018

Int J Clin Anesth Res

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“…Our result was in line with the study carried by Channabasappa et al [10], who added dexmedetomidine to local anesthetics used for peribulbar anesthesia and reported that adding dexmedetomidine shortens the onset time and prolongs the duration of sensory and motor block, and produces sedation. Poonam Nehra et al [19] compared the addition of fentanyl vs. clonidine (alpha 2 agonist) to local anaesthetic mixture during peribulbar block and reported that the onset time of globe akinesia was significantly shorter in fentanyl group (F) and clonidine group (C) compared to control group (S).…”

Section: Discussionsupporting

confidence: 82%

“…This result is support by the study done by Channabasappa et al [10], who recorded that there was a significant increase in modified Ramsay score when he used dexmedetomidine in two doses (25 μg, 50 μg) added to local anesthetics used for peribulbar block.…”

Section: Discussionsupporting

confidence: 80%

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Dexmedetomidine vs. Fentanyl as Adjuvant to Local Anaesthetic Mixture in Peribulbar Block for Retinal Surgery: A Randomized Prospective Study

Khalil¹,

Marouf²

2017

J Anesth Clin Res

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“…Addition of dexmedetomidine to lidocaine and bupivacaine in peribulbar block shortens the onset time and prolongs the duration of the block and postoperative analgesia. It also provides sedation which enables full cooperation and potentially better operating conditions [9] . In addition to this, it also decreases the intraocular pressure significantly [10] .…”

Section: Peribulbar Anaesthesiamentioning

confidence: 99%

Local Anaesthesia in Cataract Surgery

Reddy

Thevi

2017

International Journal of Ophthalmic Research

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nerves of the cornea and the conjunctiva (long and short ciliary nerves, nasociliary nerves). This technique eliminates the possible complications of injectable anesthesia. However, it does not eliminate pain sensitivity of the iris, the zonule, and the ciliary body which is achieved by intracameral technique of anesthesia with preservative free 1% lidocaine. In a constantly evolving arena, the sub-Tenon's block has gained popularity while the deep angulated intraconal (retrobulbar) block has been largely superseded by the shallower extraconal (peribulbar) approach. Hyaluronidase is a useful adjuvant because it promotes local anesthetic diffusion and hastens block onset time but there is a possibility of getting an allergic reaction. Ultrasound-guided eye blocks afford real-time visualization of needle position and local anesthetic spread. An advantage of sonic guidance is that it may eliminate the hazard of globe perforation by identifying abnormal anatomy, such as staphyloma. INTRODUCTIONThe ideal anaesthesia would be one that provides adequate pain relief during surgery and postoepratively, be easy to administer and have minimal complications. For doing cataract surgery, the anaesthesia could be local or general. Majority of cataract patients are operated under local anaesthesia (infiltration, topical, intracameral). The infiltration anaesthesia is given as retrobulbar or peribulbar or subTenon's block. Carl Koller first used cocaine as a topical anaesthetic for eye surgery in 1884 [1] . The general anaesthesia has its own complications in elderly cataract patients and most of them may have diabetes or hypertension or heart diseases or combination of them. No need of fasting before or after surgery, no need of intubation, no need of using any systemic medications are the advantages of local anaesthesia. However, cataract in children, patients with parkinsonism, deaf mute patients, mental retardation patients, patients ABSTRACTThere has been a significant evolution in surgical technique of cataract extraction. The technical advances in phaco machines, phacotips, and availability of ophthalmic viscoelastic devices have played a great role in cataract surgery to be faster and more controlled now than before. Similarly, local anesthesia techniques in cataract surgery have also advanced significantly from retrobulbar, peribulbar, sub-Tenon's, to topical anaesthesia. Even though, the sub-Tenon's anesthesia technique reduced the risk of complications of peribulbar/ retrobulbar anesthesia but the technique is still associated with a possibility of damage to optic nerve, retrobulbar hemorrhage, and ocular muscle injury. Topical anesthesia is used to block the afferent EDITORIAL

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Efficacy and safety of dexmedetomidine as an additive to local anesthetics in peribulbar block for cataract surgery

Cited by 35 publications

References 14 publications

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

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

Dexmedetomidine vs. Fentanyl as Adjuvant to Local Anaesthetic Mixture in Peribulbar Block for Retinal Surgery: A Randomized Prospective Study

Local Anaesthesia in Cataract Surgery

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