Peribulbar Block Using Dexmedetomdine versus Magnesium Sulphate as Additives to Local Anesthetics for Cataract Surgery

Elmoniem, Manal Foad Abd; Kamel, Rehab M

doi:10.21608/ejhm.2019.31586

Cited by 2 publications

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“…In ophthalmic-regional anesthesia, most of the clinical studies evaluated magnesium sulfate as adjuvant to the local anesthetics comparing with other agents in peribulbar block as standard procedure for cataract surgery. [ 2 4 6 18 ] To our knowledge, no study has evaluated its usefulness in sub-Tenon block. We studied the usual dose (50 mg) of magnesium sulfate added to the standard mixture of local anesthetic in sub-Tenon anesthesia and compared it to a control group.…”

Section: Discussionmentioning

confidence: 99%

“…To enhance the onset, duration and efficacy of local anesthetics, various adjuvants are being used with local anesthetics. The most commonly used adjuvants are opioids,[ 4 ] alpha-2 adrenoreceptor agonist,[ 5 6 ] steroids,[ 7 ] nonsteroidal anti-inflammatory drugs,[ 8 ] muscle relaxants,[ 9 10 ] and magnesium sulfate. These agents may cause some side effects like allergic reaction, bradycardia, sedation, and systemic neuromuscular blockade.…”

Section: Introductionmentioning

confidence: 99%

“…It has also been used in ophthalmic peribulbar anesthesia and found to reduce the time to the onset of action, prolonged duration, and improved quality of block. It is a safe drug, and most studies showed no side effects with its use at the single dose of 50 mg.[ 2 4 6 18 ]…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of magnesium sulfate as an adjuvant in sub-Tenon anesthesia for cataract surgery

Ahmad

Zahoor

Font³

et al. 2023

Saudi Journal of Anaesthesia

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Purpose: To evaluate the efficacy, safety, and satisfaction for the use of adjuvant; magnesium sulfate (MgSO 4 ) in sub-Tenon anesthesia for cataract surgery. Methods: This single centered randomized, double blind trial was held in 2021 after approval of ethical committee at the Eye Hospital, Riyadh, Saudi Arabia. Cataract patients to be operated using local anesthesia were randomly assigned to two groups; Group magnesium sulfate (MS) received 50 mg/0.5 ml of magnesium sulfate and Group normal saline (NS) received 0.5 ml of normal saline added to the standard mixture, respectively. Absence of eyelid dropping and akinesia of the globe at different time after anesthesia were considered as ineffective anesthesia. The age and sex-adjusted generalized estimating equation (GEE) analysis was carried out. Complications, patient's and surgeon's satisfaction were also compared. Results: Each group had 100 cataract patients. Effectiveness of block was not significantly different in two groups (adjusted odds ratio, 0.90; 95% confidence interval [CI], 0.62, 1.31; P = 0.594). The likelihood of “no eye-opening” significantly increased with time (adjusted odds ratio, 1.26; 95% CI, 1.18–1.34; P < 0.001). Subconjunctival bleeding was significantly higher in the MS versus NS Group (36 of 98 [36.7%] vs. 11 of 102 [10.8%], P < 0.001). Chemosis was not significantly different between the groups ( P = 0.95). Patient's satisfaction score was very good (9/10) but slightly higher in NS group than MS ( P = 0.001) while surgeon's satisfaction score was similar in both groups ( P = 0.149). Conclusions: Although safe, adding 50 mg of magnesium sulfate did not improve the effect of sub-Tenon anesthesia for cataract surgery. Risk of subconjunctival bleeding was higher in cataract patients operated using MgSO 4 compared to those managed with the conventional sub-Tenon anesthetic.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of magnesium sulfate as an adjuvant in sub-Tenon anesthesia for cataract surgery

Ahmad

Zahoor

Font³

et al. 2023

Saudi Journal of Anaesthesia

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Oculocardiac reflex in phacoemulsification

Dandekar¹,

Mohan²,

Baranwal³

2021

Indian Journal of Ophthalmology

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Purpose: This study compares the vital parameters and pain experienced during phacoemulsification under peribulbar and topical anesthesia to determine the incidence of OCR. Methods: One hundred six patients are enrolled for phacoemulsification in a prospective and randomized study. Fifty-two patients undergo surgery in a peribulbar block (Group PB) and 54 in topical anesthesia (Group TA). Mean arterial pressure (MAP) and pulse rate are recorded during a preoperative check-up and at four other steps of surgery. Pain experienced during surgery and on a postoperative day, 5, is graded with a verbal analogue scale. OCR defined as a decrease in pulse rate by greater than 20% is calculated. Chi-square test, Fisher‘s exact test, paired t test and the comparison of means give the statistical analysis. A value of P < 0.05 was taken as significant. Results: MAP readings at baseline versus MAP at other steps of surgery show a trend towards rising with a P value of < 0.05 in both groups. Pulse rate measured at all steps of surgery versus baseline pulse rate in Group TA shows P < 0.05. OCR is present in nine patients in peribulbar block verses eleven patients in topical anesthesia with P value of 0.687. The pain scores using verbal analogue scale were higher in Group TA compared with Group PB with a P < 0.0001. Conclusion: Oculocardiac reflex can occur during phacoemulsification under both peribulbar block and topical anesthesia, and the difference is not significant.

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Peribulbar Block Using Dexmedetomdine versus Magnesium Sulphate as Additives to Local Anesthetics for Cataract Surgery

Cited by 2 publications

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Evaluation of magnesium sulfate as an adjuvant in sub-Tenon anesthesia for cataract surgery

Evaluation of magnesium sulfate as an adjuvant in sub-Tenon anesthesia for cataract surgery

Oculocardiac reflex in phacoemulsification

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