Effect of clonidine added to lidocaine for sub-Tenon’s (episcleral) anesthesia in cataract surgery

Cabral, Sigmar Aurea; Carraretto, Antônio Roberto; Brocco, Marcos Célio; Baptista, João Florêncio Abreu; Gomez, Renato Santiago

doi:10.1007/s00540-013-1660-2

Cited by 12 publications

(5 citation statements)

References 18 publications

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“…Several studies have shown favorable results of opioids the combination with local drugs, such as lidocaine and fentanyl, in increasing the effect and depth of local anesthesia. In the study of Cabral et al on local anesthesia for cataract surgery, adding clonidine to lidocaine for subtenon anesthesia increased the duration of anesthesia and immobilization of the eye and analgesia (11).…”

Section: Discussionmentioning

confidence: 99%

Comparing the effect of local injection of combined morphine, triamcinolone and lidocaine and lidocaine injection on pain intensity after mastoidectomy-tympanoplasty; a triple-blind clinical trial

Talakoub,

Khalili,

Rohani

2023

Immunopathol Persa

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Introduction: Postoperative pain control is one of the patient’s rights and the challenges of surgeons and anesthesiologists since about 20% of patients experience severe pain in the first 24 hours after surgery. Mastoidectomy and tympanoplasty are common surgeries in the head and neck area, in which profound and long-term analgesia is essential. Objectives: The present study investigated the effect of the combination of topical morphine, triamcinolone, and lidocaine compared to the control group. Patients and Methods: In the current clinical trial, 68 patients’ candidates for mastoidectomy-tympanoplasty surgery were included and randomly divided into intervention and control groups. The variables of demographic, pain, hemodynamics, extubation time, and received opioids were measured. Results: The results of the current study indicated a significant reduction in the patient’s pain scores in both groups (P=0.001), while the patients of group 1 had significantly lower pain scores than group 2 after 8, 12, and 24 hours in the ward (P<0.05). Moreover, a significant reduction was observed in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in all patients during surgery (P<0.001). However, in patients who received morphine, triamcinolone, and lidocaine (group 1), SBP and MAP were significantly lower than group 2 after 40, 80, 100, 120, 140, and 160 minutes during surgery (P<0.05). Conclusion: The present study indicated that the combination of morphine, triamcinolone, and lidocaine compared to the control group could lead to better pain control, further reduction of SBP and MAP, reduction of post-operative opioid use, and delay during the first opioid administration. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20200825048515N39; https://irct.ir/trial/57931, ethical code; IR.MUI.MED.REC.1400.064).

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Section: Discussionmentioning

confidence: 99%

Comparing the effect of local injection of combined morphine, triamcinolone and lidocaine and lidocaine injection on pain intensity after mastoidectomy-tympanoplasty; a triple-blind clinical trial

Talakoub,

Khalili,

Rohani

2023

Immunopathol Persa

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“…The final anesthetic solution volume was 6 mL, and the doses of lidocaine and clonidine used were based on previous studies. 11 , 18 , 22 Patients were monitored with electrocardiogram, Mean Arterial Pressure (MAP), Heart Rate (HR), and Oxygen Saturation (SpO 2 ), preoperatively. A 22G intravenous catheter in the upper limb was used for peripheral venous access of infusion of 0.9% sodium chloride solution.…”

Section: Methodsmentioning

confidence: 99%

“…Clonidine is a central and peripheral α2 adrenergic receptor agonist. It has been used as an adjuvant during regional ophthalmic anesthesia due to its analgesic properties 16 with potentiation of motor and sensory blocks, 17 , 18 , 19 , 20 , 21 , 22 as well as IOP reduction. 17 , 21 Studies, however, were performed to assess the quality of anesthesia and did not assess the effects of clonidine on ocular hemodynamics in ophthalmic blocks.…”

Section: Introductionmentioning

confidence: 99%

Effect of adding clonidine to lidocaine on ocular hemodynamics during sub-Tenon’s anesthesia: randomized double-blind study

Cabral

Carraretto

Sousa

et al. 2021

Brazilian Journal of Anesthesiology (English Edition)

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“…The addition of clonidine 1 μg/kg to 2 % lidocaine in sub-Tenon's anesthesia for cataract surgery increased the duration of sensory anesthesia, ocular akinesia, and the duration of analgesia [15] .…”

Section: Sub-tenon's Anaesthesiamentioning

confidence: 99%

Local Anaesthesia in Cataract Surgery

Reddy

Thevi

2017

International Journal of Ophthalmic Research

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nerves of the cornea and the conjunctiva (long and short ciliary nerves, nasociliary nerves). This technique eliminates the possible complications of injectable anesthesia. However, it does not eliminate pain sensitivity of the iris, the zonule, and the ciliary body which is achieved by intracameral technique of anesthesia with preservative free 1% lidocaine. In a constantly evolving arena, the sub-Tenon's block has gained popularity while the deep angulated intraconal (retrobulbar) block has been largely superseded by the shallower extraconal (peribulbar) approach. Hyaluronidase is a useful adjuvant because it promotes local anesthetic diffusion and hastens block onset time but there is a possibility of getting an allergic reaction. Ultrasound-guided eye blocks afford real-time visualization of needle position and local anesthetic spread. An advantage of sonic guidance is that it may eliminate the hazard of globe perforation by identifying abnormal anatomy, such as staphyloma. INTRODUCTIONThe ideal anaesthesia would be one that provides adequate pain relief during surgery and postoepratively, be easy to administer and have minimal complications. For doing cataract surgery, the anaesthesia could be local or general. Majority of cataract patients are operated under local anaesthesia (infiltration, topical, intracameral). The infiltration anaesthesia is given as retrobulbar or peribulbar or subTenon's block. Carl Koller first used cocaine as a topical anaesthetic for eye surgery in 1884 [1] . The general anaesthesia has its own complications in elderly cataract patients and most of them may have diabetes or hypertension or heart diseases or combination of them. No need of fasting before or after surgery, no need of intubation, no need of using any systemic medications are the advantages of local anaesthesia. However, cataract in children, patients with parkinsonism, deaf mute patients, mental retardation patients, patients ABSTRACTThere has been a significant evolution in surgical technique of cataract extraction. The technical advances in phaco machines, phacotips, and availability of ophthalmic viscoelastic devices have played a great role in cataract surgery to be faster and more controlled now than before. Similarly, local anesthesia techniques in cataract surgery have also advanced significantly from retrobulbar, peribulbar, sub-Tenon's, to topical anaesthesia. Even though, the sub-Tenon's anesthesia technique reduced the risk of complications of peribulbar/ retrobulbar anesthesia but the technique is still associated with a possibility of damage to optic nerve, retrobulbar hemorrhage, and ocular muscle injury. Topical anesthesia is used to block the afferent EDITORIAL

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Effect of clonidine added to lidocaine for sub-Tenon’s (episcleral) anesthesia in cataract surgery

Abstract: The addition of clonidine 1 μg/kg to 2 % lidocaine in sub-Tenon's anesthesia for cataract surgery increased the duration of sensory anesthesia, ocular akinesia, and the duration of analgesia.

Cited by 12 publications

References 18 publications

Comparing the effect of local injection of combined morphine, triamcinolone and lidocaine and lidocaine injection on pain intensity after mastoidectomy-tympanoplasty; a triple-blind clinical trial

Comparing the effect of local injection of combined morphine, triamcinolone and lidocaine and lidocaine injection on pain intensity after mastoidectomy-tympanoplasty; a triple-blind clinical trial

Effect of adding clonidine to lidocaine on ocular hemodynamics during sub-Tenon’s anesthesia: randomized double-blind study

Local Anaesthesia in Cataract Surgery

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