Peribulbar anaesthesia using a mixture of local anaesthetic and vecuronium

Abstract

SummaryThe aim of this double-blind, randomised study was to assess the effects of the addition of 0.5 mg of vecuronium bromide to a standard local anaesthetic mixture used for peribulbar anaesthesia. We studied 60 patients undergoing regional anaesthesia for intra-ocular surgery and were primarily interested in the quality of globe and lid akinesia. All received a mixture of 5 ml 2% lignocaine with 1:200 000 adrenaline, 5 ml 0.75% bupivacaine and 150 IU hyaluronidase with either 0.9% saline 0.25 ml (group A, n ¼ 30) or vecuronium bromide 0.25 ml (0.5 mg) (group B, n ¼ 30). Eye movements assessed at both 5 and 10 min were significantly reduced in the vecuronium group (group B) (p < 0.05). We conclude that the addition of vecuronium at a dose of 0.5 mg to the standard local anaesthetic mixture improves the quality of globe and lid akinesia.

Adjuvants to local anaesthesia in ophthalmic surgery

“…In an effort to overcome incomplete akinesia Reah et al 44 added 0.5 mg of vecuronium to peribulbar blocks and found that globe and lid akinesia was improved at 5 and 10 min compared with control. No adverse effects occurred in the vecuronium group.…”

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

“…Some clinical trials have shown that the addition of a neuromuscular blocker (e.g., vecuronium or pancronium) to the local anesthetic solution improves the quality of anesthesia in different regional techniques. 2,3 The aim of this study was to determine whether the addition of low-dose atracurium to a local anesthetic mixture had any effects on onset time or duration of akinesia in peribulbar block.…”

Dexmedetomidine vs. Magnesium Sulphate as an Adjuvant to Rocuronium Bromide, and Local Anaesthetic Mixture in Peribulbar Anaesthesia for Viteroretinal Surgery

“…Using nondepolarizing muscle relaxants such as atracurium [10], vecuronium [9] and rocuronium [11], as adjuvants to local anesthetics in peribulbar anesthesia has been proved in several studies to improve the quality and the duration of the block.…”

“…Neuromuscular blocking drugs, such as vecuronium [9] and atracrurium [10], and rocuronium have also been added to the local anaesthetic mixture and have been shown to accelerate onset and improve the quality of peribulbar block [11].…”