Comparison between Single-Injection Inferomedial and Inferotemporal Peribulbar Blockades before Cataract Surgery

Mahdy, Reda A.; Ghanem, Mohamed T.

doi:10.1159/000329865

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…A lesser volume of anesthetic agent, even if injected close to muscle, may carry a lower risk of potential myotoxicity. Mahdy et al found inferomedial block to be more effective and requiring only around 5 ml of anaesthetic agents 6 . In the present study, a total volume of 5 ml of the local anesthetic agent was further divided into 3 ml and 2 ml in the inferomedial and superomedial quadrants respectively, thereby avoiding the concentration of large volume of the agent close to a single muscle.…”

Section: Discussionmentioning

confidence: 80%

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Does the addition of hyaluronidase improve the quality of peribulbar anesthesia in cataract surgery? – A randomized double blinded study

Nagarajan

Srikanth

Venipriya

2018

Saudi Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 80%

“…With the gaze fixed ahead in the primary position, 3 ml of the anesthetic solution was deposited inferomedially. Ocular massage was given for 30 s by hand followed by another injection of 2 ml superomedially 6 . The stop clock was started on withdrawal of the needle after the first inferomedial injection.…”

Section: Methodsmentioning

confidence: 99%

Does the addition of hyaluronidase improve the quality of peribulbar anesthesia in cataract surgery? – A randomized double blinded study

Nagarajan

Srikanth

Venipriya

2018

Saudi Journal of Ophthalmology

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“…The efficacy of this technique has been previously reported. B-scan ultrasonography has been used to ascertain the distribution pattern of the injectate in peribulbar anesthesia (8)(9)(10) . We named it inferomedial injection in our study after its anatomical site to facilitate the description throughout this manuscript.…”

Section: Introductionmentioning

confidence: 99%

Assessing The Efficacy of Single Inferomedial Peribulbar Injection in Lacrimal Intubation Surgery in Adult Patients: A Randomized Clinical Trial

Salem¹,

Mohamed²,

Mahmoud³

2023

The Egyptian Journal of Hospital Medicine

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Background: Inferomedial injection has been suggested as a more comfortable alternative to medial peribulbar block. Aim: We aimed to explore inferomedial injection technique efficacy in minimizing pain during injection as well as intubation compared to the classic medial canthal injection technique during peribulbar block. Methods: This randomized, controlled trial included adult (18 to 70 year-old) patients scheduled for lacrimal intubation surgery. Eligible patients were divided in a random way into two groups. Group 1 (n=24) received inferomedial peribulbar injection using a 25G/ 1" length needle to inject 3 ml of lidocaine: bupivacaine (1: 1) with 30 IU hyaluronidase enzyme to improve the infiltration of the small volume of the local anesthetic drugs. The classic medial canthus injection was applied in Group 2 (n=24) using the same types and amounts of local anesthesia (LA) and the same needle length. The pain was assessed during local anesthetics injection and intubation using the verbal rating scale. Results:In group 1 a low pain score was more frequent than in group 2 (83.3% vs. 16.7%). The median pain score at the LA injection was significantly lower in group 1 (1.0: IQR=1.0-1.0) than in group 2 (2.0: IQR=2.0-2.5). Alternatively, a comparison of the Verbal Rating Scale at intubation revealed comparable results between groups 1 and 2, with no significant differences (p>0.05). Conclusions: Inferomedial LA injection technique is feasible and less painful than the medial canthal injection. Otherwise, both techniques provided adequate intraoperative analgesia during lacrimal intubation and comparable surgeon satisfaction.

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Adding low dose rocuronium to local anesthetic mixture: Effect on quality of peribulbar blockade for vitreoretinal surgery

Ghanem

Tawfeek

2016

Egyptian Journal of Anaesthesia

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Background: The purpose of this study was to assess the effect of adding low dose rocuronium to local anesthetic solution on the quality of peribulbar blockade for vitreoretinal (VR) surgery. Methods: 80 consecutive adult patients scheduled for VR surgery were enrolled in this double-blind randomized clinical trial. Patients were categorized randomly into 2 equal groups: group C (control group) received local anesthetic mixture (4 ml lidocaine 2%, 4 ml bupivacaine 0.5%, and hyaluronidase ''30 U/ml") plus 0.5 ml normal saline, and group S (study group) received the same local anesthetic mixture plus 5 mg (0.5 ml) rocuronium. Globe and lid akinesia were assessed 15 min after injection, and supplemental peribulbar blockade was done in case of inadequate analgesia and or akinesia. Intraoperatively, supplementary sub-Tenon infiltration was performed in case of inadequate analgesia and/or akinesia. Measurement data included rate of supplementation, analgesic efficacy, time to first sub-Tenon infiltration, and total anesthetic volume. Major complications, and patient's and surgeon's satisfaction were also recorded. Results: The adequacy of peribulbar blockade 15 min after injection was comparable in both groups. Rate of supplementary sub-Tenon infiltration was lower in the rocuronium group which is statistically significant (15 injections versus 53 injections in the control group). Time to first sub-Tenon infiltration was significantly prolonged in the rocuronium group (90.4 + 11.8 versus 60.2 + 9.2 in the control group). The total anesthetic volume injected was significantly lower in the rocuronium group (13.2 + 0.6 versus 20.6 + 0.8 in the control group). There were no major systemic or local complications in both groups. Patient's and surgeon's satisfaction was significantly higher in the rocuronium group. Conclusion: Adding low dose rocuronium to local anesthetics prolongs duration of peribulbar anesthesia and offers an optimal surgical condition without serious adverse effects for patients undergoing VR surgery.

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Comparison between Single-Injection Inferomedial and Inferotemporal Peribulbar Blockades before Cataract Surgery

Cited by 4 publications

References 31 publications

Does the addition of hyaluronidase improve the quality of peribulbar anesthesia in cataract surgery? – A randomized double blinded study

Does the addition of hyaluronidase improve the quality of peribulbar anesthesia in cataract surgery? – A randomized double blinded study

Assessing The Efficacy of Single Inferomedial Peribulbar Injection in Lacrimal Intubation Surgery in Adult Patients: A Randomized Clinical Trial

Adding low dose rocuronium to local anesthetic mixture: Effect on quality of peribulbar blockade for vitreoretinal surgery

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