It is well established that reduced size dilating eye drops of 1% tropicamide and 10% phenylephrine (micro drops) are effective for clinical purposes. Excellent pupil dilatation (mydriasis) is achieved and pupil constriction does not occur in response to light. In this study, the effect of micro drops of 1% tropicamide on distance and near visual recovery was compared with standard drops in a group of 20 healthy volunteers. For each person studied, one eye was selected at random to be tested first with the standard drop size, and then after a minimum of one week, the same eye was again tested using a drop of the same drug one fifth standard size. An iris photograph, Snellen visual acuity at 6 m, and reading visual acuity was obtained for each test procedure: before drop instillation and at 30 min, 1, 2 and 4 h after drug instillation. Use of the micro drops caused a small but statistically significant improvement in the rate of recovery of distance and near visual acuity. These findings, allied to the known beneficial effects of reduced systemic absorption using micro drops, lend further weight to the argument that mydriasis may be achieved more safely, with fewer side effects, and with earlier return of normal vision when reduced size drops are used. It is hoped that practical micro drop dispensers will be developed.
Background: Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anaesthesia. The aim of this study is to compare the effects of adding fentanyl to low dose bupivacaine in 44 (30, 60) and 63 (30,80) minutes for Group I and Group II respectively (P=0.000). Conclusions: Spinal anaesthesia in elderly patients using low dose bupivacaine (10 mg) combined with 25 μg fentanyl is associated with a lower incidence of haemodynamic instability, better quality and prolonged duration.
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