An evaluation of two concentrations of hyaluronidase for supplementation of peribulbar anaesthesia

Brydon, C.; Basler, Michael; Kerr, William J.

doi:10.1111/j.1365-2044.1995.tb05940.x

Cited by 20 publications

(28 citation statements)

References 8 publications

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“…However, our third injection rates were similar to Lewis at 32% and 24% for levobupivacaine and racemic bupivacaine, respectively. Brydon et al used a two injection 8 ml technique to compare different hyaluronidase concentrations with 0.75% bupivacaine and 2% lignocaine for peribulbar anaesthesia [19]. They used a block score of less than 4 out of 8 with a marked block in all directions of gaze at 10 min as their end point for further injections.…”

Section: ¹1mentioning

confidence: 99%

Comparison of 0.75% levobupivacaine with 0.75% racemic bupivacaine for peribulbar anaesthesia

McLure

Rubin

1998

Anaesthesia

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SummaryIn a single centre, randomised, double-blind study 50 patients scheduled for intra-ocular surgery received 0.75% levobupivacaine or 0.75% racemic bupivacaine for peribulbar anaesthesia. There were no significant differences in the mean (SD) volume of levobupivacaine (11 (2.7) ml) or racemic bupivacaine (10 (2.6) ml) required, time to satisfactory block (levobupivacaine -13 (5.6) min; racemic bupivacaine -11 (4.4) min), peri-operative pain scores or frequency of adverse events between levobupivacaine and racemic bupivacaine. The safer side-effect profile of levobupivacaine may offer significant advantages in the elderly population undergoing cataract extraction in whom intercurrent disease is common.

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Section: ¹1mentioning

confidence: 99%

Comparison of 0.75% levobupivacaine with 0.75% racemic bupivacaine for peribulbar anaesthesia

McLure

Rubin

1998

Anaesthesia

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“…A beneficial effect has been recorded with doses of 3.75-300 IU/ml, whereas others have been unable to demonstrate a difference with doses of 0.75-150 IU/ml. [3][4][5][6][7] Some of this discrepancy may relate to differences in the technique, differences in the type and volume of injected local anaesthetic, and problems with the assessment of akinesia.…”

Section: Introductionmentioning

confidence: 99%

The effect of hyaluronidase on ultrasound-measured dispersal of local anaesthetic following sub-Tenon injection

Khandwala

Ahmed

Goel

et al. 2007

Eye

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Purpose To determine by B-scan ultrasonography if the addition of hyaluronidase affects the dispersal of anaesthetic fluid after sub-Tenon's injection. Design Single-centre prospective randomised double-blind study. Materials and methods We performed a trial in 19 patients who were randomised to receive 5 ml of lidocaine 2% alone, or with hyaluronidase 15 IU/ml. A pre-anaesthetic B-scan ultrasound was performed followed by a standard infero-nasal sub-Tenon's injection. Further B-scan ultrasound studies were performed at 1, 3, and 5 min recording depth of local anaesthetic fluid. Data was analysed with Fisher's exact test and Student's t-test where appropriate. Results were considered significant when Po0.05. Results The maximum depth of local anaesthetic was significantly less in the hyaluronidase group than the control group at 3 and 5 min (0.79 vs 1.65 mm, P-value 0.01 and 0.43 vs 1.52 mm, P-value 0.002 respectively). There were no statistically significant differences in the akinesia, pain and surgical satisfaction scores between the two groups. Conclusions The addition of hyaluronidase significantly augments the dispersal of local anaesthetic fluid, as measured by B-scan ultrasonography.

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“…Some studies had documented the improvement the quality of ocular akinesia with the utilization of hyaluronidase as a part LA solution for PBB [22][23][24][25]. While other studies failed to prove this effects [26,27,21,28].…”

Section: Discussionmentioning

confidence: 99%

The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery

Elyazed

Abdelghafar

Mogahed

et al. 2017

Egyptian Journal of Anaesthesia

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2017) The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery, Egyptian Journal of Anaesthesia, 33:3, 245-250, a b s t r a c t Background: Several adjuvants can be utilized to improve the quality of peribulbar block (PBB). We compared the effects of adding cisatracurium or hyaluronidase to levobupivacaine and lidocaine mixture for PBB on the onset of globe and lid akinesia in cataract surgery. Methods: 105 adult patients scheduled for cataract surgery under PBB were randomly allocated into three groups. Control group received 4 ml 0.5% levobupivacaine plus 3 ml 2% lidocaine diluted in saline to a total volume of 8 ml. Hyaluronidase 15 IU/ml and cisatracurium 1 mg were added to local anesthetics (LAs) mixture in hyaluronidase and cisatracurium groups respectively. Onset and duration of lid and globe akinesia, time for adequate conditions to start surgery and adverse events were recorded. Distribution of LAs solution was evaluated by B-scan ultrasound at 3 min and 10 min after injection of LAs. Results: Onset of lid and globe akinesia, as well as time to adequate conditions to start surgery, were faster in cisatracurium and hyaluronidase groups compared to the control group (P < 0.05). Cisatracurium group had the fastest onset. At 3 min after injection of LAs, the ultrasound examination revealed that hyaluronidase group had the highest percentage of patients showing intraconal diffusion of LAs solution with the appearance of a characteristic T sign (P < 0.05).Conclusions: The addition of cisatracurium 1 mg or hyaluronidase 15 IU/ml to levobupivacaine and lidocaine mixture for PBB hastened the onset of lid and globe akinesia without increase the incidence of adverse effects. This effect is more obvious with cisatracurium compared to hyaluronidase.

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An evaluation of two concentrations of hyaluronidase for supplementation of peribulbar anaesthesia

Cited by 20 publications

References 8 publications

Comparison of 0.75% levobupivacaine with 0.75% racemic bupivacaine for peribulbar anaesthesia

Comparison of 0.75% levobupivacaine with 0.75% racemic bupivacaine for peribulbar anaesthesia

The effect of hyaluronidase on ultrasound-measured dispersal of local anaesthetic following sub-Tenon injection

The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery

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