Effects of atracurium added to local anesthetics on akinesia in peribulbar block

Küçükyavuz, Zuhal; Arıcı, Mustafa Kemal

doi:10.1053/rapm.2002.34334

Cited by 16 publications

(9 citation statements)

References 18 publications

(19 reference statements)

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“…The results of this study are consistent with those reported by Kucukyavuz and Arici[8] who have demonstrated that the addition of atracurium 5 mg to a mixture of lidocaine 2% and bupivacaine 0.5% improve orbital akinesia and hasten block onset time. Reah and colleagues[7] have also shown similar results when vecuronium is added to a standard mixture of lidocaine and bupivacaine, however, they have also added hyaluronidase 150 U to their local anesthetic mixture which was not the case in our study.…”

Section: Discussionsupporting

confidence: 92%

“…[3] To overcome these limitations, many adjuvant drugs[4–6] such as adrenaline, sodium bicarbonate, and hyaluronidase have been added to the local anesthetic mixture used for peribulbar block in order to augment its efficacy and hasten its speed of onset; however, their effects have been variable. Neuromuscular blocking drugs, such as vecuronium[7] and atracurium,[8] have also been added to the local anesthetic mixture and have been shown to improve the quality of peribulbar anesthesia. Atracurium, however, has histamine-releasing property and could result in undesirable local hyperemia.…”

Section: Introductionmentioning

confidence: 99%

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Effects of local low-dose rocuronium on the quality of peribulbar anesthesia for cataract surgery

et al. 2011

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Objectives:Peribulbar anesthesia is associated with delayed and/or incomplete orbital akinesia compared with retrobulbar anesthesia. This study examined the effects of adding rocuronium 5 mg to two different concentrations of lidocaine-bupivacaine mixture on onset time of orbital and eyelid akinesia in patients undergoing cataract surgery.Methods:In a double-blind study, 90 patients were equally randomized to receive a mixture of 0.5 ml normal saline, 4 ml lidocaine 2%, and 4 ml bupivacaine 0.5% (group I), a mixture of rocuronium 0.5 ml (5 mg), 4 ml lidocaine 2%, and 4 ml bupivacaine 0.5% (group II), or a mixture of rocuronium 0.5 ml (5 mg), 4 ml lidocaine 1%, and 4 ml bupivacaine 0.25% (group III). Orbital akinesia was assessed on a 0-8 score (0 = no movement, 8 = normal) at 2 min intervals for 10 min. Time to adequate anesthesia was also recorded. Results are presented as mean±SD.Results:Ocular movement score decreased during the assessment period in all groups. However, at 2 min after block administration, the score decreased to 4±2 (95% CI 3,5) in groups II and III compared with 5±2 (95% CI 4,6) in group I (P<0.01). Time to adequate condition to begin surgery was 9.8±2.9 vs. 6.9±4.1 vs. 7.9±3.9 min for groups I, II, and III, respectively (P=0.01).Conclusion:The addition of rocuronium 5 mg to a mixture of lidocaine 2% and bupivacaine 0.5% shortened the onset time of peribulbar anesthesia in patients undergoing cataract surgery without causing adverse effects.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Effects of local low-dose rocuronium on the quality of peribulbar anesthesia for cataract surgery

et al. 2011

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“…The use of vasoconstrictors (eg, adrenaline) is not recommended due to the potential for these to further lower ocular blood flow 69. The addition of clonidine and muscle relaxants have also been described 70–72…”

Section: Choice Of Local Anesthetic Solutions For Sub-tenon’s Anesthesiamentioning

confidence: 99%

Sub-Tenon's anesthesia: an update

Guise¹

2012

LRA

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“…[ 14 ] who have demonstrated that the addition of vecuronium in a dose of 0.5 mg to a mixture of lidocaine 2%, bupivacaine 0.5%, and hyaluronidase 150 U improve globe and lid akinesia and hasten block onset time without side effects. Küçükyavuz and Arici[ 13 ] have also shown similar results when atracurium 5 mg was added to a standard mixture of lidocaine and bupivacaine without hyaluronidase. In addition, Aissaoui et al .…”

Section: Discussionmentioning

confidence: 64%

“…Neuromuscular blocking drugs, such as atracurium[ 13 ] and vecuronium,[ 14 ] have also been added to the local anesthetic mixture and have been shown to improve the quality of PBA. Histamine-releasing property of atracurium could result in undesirable local hyperemia.…”

Section: Introductionmentioning

confidence: 99%

Comparison of orbital muscle akinesia caused by rocuronium versus hyaluronidase mixed to the local anesthetic in single injection peribulbar block for cataract surgery

Messeha

Elhesy

2015

Anesth Essays Res

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Background:The aim of this study was to compare orbital muscle akinesia caused by rocuronium versus hyaluronidase when mixed with the local anesthetic in single-injection peribulbar anesthesia (PBA).Patients and Methods:Sixty patients were included in the study and subjected to cataract extraction using phacoemulsification technique with intraocular lens implantation. Group I received peribulbar block with 5 ml mixture of 30 IU/ml hyaluronidase and 2% lidocaine. Group II received peribulbar block with 5 ml mixture of rocuronium 5 mg and 2% lidocaine. The onset and duration of akinesia were assessed; the akinesia score at 2, 5, and 10 min was measured after injection. The need for supplementary injection was also recorded.Results and Conclusion:PBA using a mixture of rocuronium and lidocaine provides optimal globe akinesia and faster establishment of suitable conditions to start eye surgery and shortens the block onset time as compared with the addition of hyaluronidase to lidocaine.

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Effects of atracurium added to local anesthetics on akinesia in peribulbar block

Abstract: Atracurium added at a dose of 5 mg to a lidocaine-bupivacaine mixture for peribulbar block decreases the onset time of akinesia and provides better surgical conditions without obvious side-effects.

Cited by 16 publications

References 18 publications

Effects of local low-dose rocuronium on the quality of peribulbar anesthesia for cataract surgery

Effects of local low-dose rocuronium on the quality of peribulbar anesthesia for cataract surgery

Sub-Tenon's anesthesia: an update

Comparison of orbital muscle akinesia caused by rocuronium versus hyaluronidase mixed to the local anesthetic in single injection peribulbar block for cataract surgery

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