Efficacy of regional anesthesia in episcleral surgery: a randomized controlled double-blind clinical study

Abstract

BACKGROUND: Surgical interventions for severe fundus diseases associated with diabetes mellitus, proliferative processes against the background of retinal detachment, and acute inflammatory diseases require the development of multimodal algorithms to provide sufficient analgesic and anti-inflammatory effects.
 AIM: To evaluate the efficacy of combined pterygopalatine blockade (PPB) and retrobulbar blockade (RBB) in patients with episcleral retinal detachment surgery.
 MATERIALS AND METHODS: The study included 100 patients who underwent episcleral surgery for retinal detachment. All patients were randomized into two groups: group 1 (retrobulbar blockade, n=50) and group 2 (pterygopalatine blockade in combination with retrobulbar blockade, n=50). The level of akinesia, volume of local anesthetic, consumption of analgesics, pain, and postoperative nausea and vomiting (PONV) were evaluated.
 RESULTS: In group 2, only 12% of the patients were prescribed promedol 2% intraoperatively, which is significantly lower than that in group 1 (p=0.463). In group 2, the pain level 8 h after surgery according to the verbal sensation scale was 0.80.63. In group 1, the average pain score was 1.691.8 (p=0.558). PONV was observed in 4% of the patients in group 1. In group 2, no PONV occurred (p=0.563).
 CONCLUSION: The combination of PPB and RBB allows for controlling not only pain sensitivity but also vegetative, motor, and neuroendocrine manifestations associated with pain both in the intraoperative and early postoperative periods.

Integrative Artificial Intelligence in Regional Anesthesia: Enhancing Precision, Efficiency, Outcomes and Limitations

“…The ability of artificial intelligence to assimilate and interpret expansive datasets, including medical histories, genetic markers, and real-time physiological readings, facilitates the formulation of bespoke anesthetic strategies. This individual-centric approach is a paradigm shift from the one-size-fits-all methodology, enhancing patient safety and bolstering the effectiveness of anesthetic management by accommodating individual patient idiosyncrasies and associated risk elements [19]. AI predictive modelling techniques have been shown to reliably forecast patient reactions to specific anesthetic agents and dosages, which is instrumental in mitigating adverse reactions and optimizing therapeutic outcomes [20].…”

“…This collation serves not only as a testament to the progressive integration of AI into clinical practice but also as a touchstone for ongoing research in the domain, encapsulating the multifaceted impacts on patient care and clinical outcomes. Possibilities of using regional anesthesia with diode-laser transscleral cyclophotocoagulation in children [19] Regional anesthesia in pediatric ophthalmic surgery…”

“…Table provided an overview of AI applications within the scope of regional anesthesia, exploring its current utility and the limitations that necessitate further development [26]. Bersenev et al expanded AI applications in pediatric care, underscoring the versatility and adaptability of the technology [19]. Feinstein et al project a transformative impact on remote patient monitoring, heralding a new era of medical oversight [22].…”