Hyaluronidase reduces local anaesthetic volumes for sub-Tenon’s anaesthesia

Schulenburg, H.; Sri-Chandana, C.; Lyons, G.; Columb, Malachy O.; McLure, H. A.

doi:10.1093/bja/aem272

Cited by 33 publications

(26 citation statements)

References 23 publications

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“…Schulenburg et al 24 performed a double-blind RCT using a minimum local anaesthetic volume (MLAV) design. Patients received a sub-Tenon's 2% lignocaine injection with or without 15 IU ml −1 hyaluronidase.…”

Section: Hyaluronidasementioning

confidence: 99%

Adjuvants to local anaesthesia in ophthalmic surgery

Adams

2011

British Journal of Ophthalmology

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This article reviews the use of adjuvants to local anaesthesia for ophthalmic regional anaesthesia. Hyaluronidase, bicarbonate, epinephrine, muscle relaxants, opiates and clonidine have all been described singly and in combination for use as an adjuvant to ophthalmic regional anaesthesia. The article focuses on the efficacy of the adjuvants with regard to improving akinesia, analgesia, speed of onset and reducing block failure. A description of the pharmacological action of each adjuvant is given followed by a review of randomised control trials, dosage and notable papers on the subject. There is no effective consensus between anaesthetists or surgeons on the use of adjuvants to local anaesthesia and it so is the purpose of this review to draw attention to the wealth of current data and allow an informed decision on the choices available.

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Section: Hyaluronidasementioning

confidence: 99%

Adjuvants to local anaesthesia in ophthalmic surgery

Adams

2011

British Journal of Ophthalmology

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“…Quality of anaesthesia, akinesia and duration of sub-Tenon's block may be affected by the size of globe, size of orbital cavity, local anaesthetic agent, volume, adjuvant administration and the use of intraocular pressure lowering device after the block [16,17]. Sub-Tenon's block is known to be effective but frequent intraoperative supplementary injections are required.…”

Section: Discussionmentioning

confidence: 99%

“…The duration of anesthesia can be extended by simply injecting additional local anaesthetic agent through the initial dissection midway through the procedure on the operating table by the operating surgeon under sterile conditions [1]. Anaesthesia, akinesia and duration of sub-Tenon's block may be affected by several factors including the size of globe, orbital cavity, anaesthetic agent, volume, adjuvant and intraocular pressure lowering device [16,17]. There are wide variations in the volume of local anaesthetic agent used which ranges from 4 -10 mls [13,18].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of single injection sub-Tenon’s block for Pars Plana Vitrectomy and associated procedures

Kumar¹,

Seet²,

Macachor³

et al. 2017

New Front Ophthalmol

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“…Although there are some reports of HA as an adjunctive in RA for ophthalmic surgery improving the efficacy and speed of nerve blocks [14][15][16][17][18][19][20], other authors do not report any beneficial effect of adjunctive HA [21][22][23]. Interestingly, Schulenburg et al [24] concluded that HA reduces the volumes needed for local anaesthesia. In addition, careful review of the literature revealed that HA has added value in terms of efficacy and speed of the anaesthesia and avoids a significant increase in intraocular pressure when small volumes (5-8 ml) are used [14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%