Efficacy and Safety of Magnesium versus Dexmedetomidine as Additives to Local Anesthetic Mixture Using Single Injection Percutaneous Peribulbar Anesthesia in Vitreoretinal Surgeries

Abstract

Background: Peribulbar block for vitreoretinal surgery is rather associated with delayed onset of globe anesthesia, akinesia and short duration of analgesia. Objective: To compare the effect of addition of Magnesium sulphate vs dexmedetomidine to standard local anesthetics mixtures on the time of onset of Globe Anesthesia, Akinesia & analgesia duration. Patients and Methods: Ninety patients of both sexes, aged 25- 75 years, ASA I-III scheduled for vitreoretinal surgery. They were randomly allocated into 3 equal groups each received peribulbar block a mixture of Levo- bupivacaine 0.5% (3 ml) + lidocaine 2% (3 ml) +120 IU hyaluronidase + Control group (C): 0.5 ml of Normal saline. Group (M): 50 mg of Magnesium sulphate in 0.5 ml normal saline. Group (D): 50 μic of dexmedetomidine in 0.5 ml normal saline. The duration of sensory, motor block, Sedation level, Intra-ocular Pressure (IOP) and surgeon satisfaction were assessed. Results: The onset of globe anesthesia and akinesia was significantly shorter in M group in comparison with D and C Groups, with a significant increase in the duration of globe analgesia and akinesia in the D Group when compared to both M & C groups. Groups D and M showed a statistically significant decrease in the IOP at 5 min and 10 min when compared to the baseline measurement of the same groups & to C Group, no complications or adverse effects related to the drug or technique were recorded. Conclusion: Magnesium sulphate as a local anesthetic adjuvant in peribulbar block is safe and comparable to dexmedetomidine regarding the sensory and motor block duration with better cost-effectiveness and availability.

Evalution of the Effect of Addition of Magnesium Sulfate to Local Anesthetics for Peribulbar Block: a Meta-Analysis for Randomized Trials

“…Those onset of globe anesthesia What's more akinesia might have been altogether shorter for m one assembly in examination for d and c Groups, for An noteworthy expand in the span of globe absense of pain and akinesia in the d assembly At contrasted with both m & c's aggregations. Assemblies d Also m indicated a statistically huge decline in the IOP toward 5 min What's more 10 min when contrasted with those benchmark estimation of the same aggregations & to c's Group, no difficulties alternately unfriendly impacts identified with the pill or method were recorded [15]. Co-administration from claiming peribulbar first mass of the magnesium nearby analgesic produces predictable fast onset from claiming anesthesia without At whatever side-effects, and also expansion of clonidine to nearby analgesic bringing about prolonged span from claiming square [16].…”

A Comparative Study on the Effects of Ketofol, Dexmedetomidine, and Isofol in Anesthesia of Candidates for Dilatation and Curettage

“…In these patients, the time of waking up and leaving anesthesia, the length of stay in recovery, various side effects (such as pain, nausea, vomiting, and confusion), and general patient satisfaction are crucial because all of them are effective in faster discharge and rehabilitation of the patient or the occurrence of surgical complications such as hematoma and surgical failure ( 14 , 15 ). Familiarity with the analgesics, along with their different applications and specific characteristics, can help to determine the best and most appropriate drug for pain control in the patients ( 16 , 17 ). Many efforts have been made to find newer analgesics and reduce the severity of postoperative pain to reduce the need for using opioid analgesics ( 18 , 19 ).…”