Peribulbar anesthesia for strabismus surgery in adult patients

Vagge, Aldo; F, Simonetti; Marenco, Maria; Burtolo, C.; Musolino, Maria; Traverso, Carlo Enrico

doi:10.1177/1120672120974947

Cited by 4 publications

(2 citation statements)

References 53 publications

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“…Compared to retrobulbar blocks, the peribulbar technique is rarely associated with serious complications like ocular perforation (5,6) . The efficacy of peribulbar anesthesia in ophthalmic surgeries has been reported in various studies (7)(8)(9)(10) . An ideal local anesthetic agent should act rapidly for an adequate duration.…”

Section: Introductionmentioning

confidence: 99%

“…Commonly, a mixture of local anesthetics is used for peribulbar anesthesia. Frequently, bupivacaine 0.5% is combined with lidocaine 2% or mepivacaine 2%, and usually hyaluronidase is added to ease the diffusion of the anesthetics in the peribulbar space (10) . However, the pain of muscle traction is not blocked by only local anesthetic drugs.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Adding Fentanyl to Peribulbar Block on Muscle Traction during Squint and Buckle Surgeries in Adult Patients: A Randomized Controlled Trial

Salem

Mohamed²,

Khattab³

et al. 2023

The Egyptian Journal of Hospital Medicine

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Background: In squint and buckle surgeries, the intraoperative pain of muscle traction might not be completely prevented by local anesthetic (LA) drugs. Adding fentanyl to LA can avoid systemic opioids side effects. Objectives: The aim of the current work was to evaluate the safety and efficacy of adding fentanyl to peribulbar block to abolish or decrease muscle traction pain during squint or buckle operations. Patients and methods: This randomized clinical trial study included a total of 60 adult patients (18-65-year-old) of both genders booked for either squint or scleral buckle surgeries, attending at Research Institute of Ophthalmology, Giza, Egypt. Patients were allocated randomly into two groups (30 patients each); fentanyl group and control group. Intraoperative pain was the primary outcome, whereas secondary outcomes included the onset of complete akinesia and patient satisfaction. Results:The median pain score was 1 for both groups. Two patients of the fentanyl group and 5 patients of the control group required general anesthesia. The mean time to achieving complete akinesia was shorter in the fentanyl group with a significant statistical difference (134.2±35.8 vs. 156.3±34.7, p = 0.018). The patient satisfaction was more with fentanyl use but with no statistical significance. Conclusions: It could be concluded that fentanyl added to the local anesthesia mixture of peribulbar block in squint and scleral buckle surgeries shorten the time needed to achieve complete akinesia. However, it does not improve the intraoperative pain resulting from muscle traction. Also, it does not affect the need for general anesthesia or postoperative patient satisfaction.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Adding Fentanyl to Peribulbar Block on Muscle Traction during Squint and Buckle Surgeries in Adult Patients: A Randomized Controlled Trial

Salem

Mohamed²,

Khattab³

et al. 2023

The Egyptian Journal of Hospital Medicine

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Levobupivacaine Combined with Cisatracurium in Peribulbar Anaesthesia in Cats Undergoing Corneal and Lens Surgery

Costa

Leonardi

Interlandi

et al. 2023

Animals

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The aims of the study included evaluating the effects of levobupivacaine combined with cisatracurium on akinesia and mydriasis when administered by peribulbar injection, and evaluating if the chosen dose of cisatracurium is enough to avoid the use of systemic neuromuscular blockade in cats. The animals were divided into four groups as follows: group L received 1.25 mg kg−1 levobupivacaine administered by peribulbar injection; group LC received the same dose of levobupivacaine combined with 0.01 mg kg−1 of cisatracurium administered by peribulbar injection; group C received 0.01 mg kg−1 of cisatracurium administered by peribulbar injection; group GC received 0.01 mg kg−1 of cisatracurium intravenously. Physiological variables, intraocular pressure, akinesia, and mydriasis were measured before and up to 30 min after peribulbar injection. The onset of akinesia, duration of akinesia, and train of four (TOF) were evaluated. Physiological variables remained in the physiological range in all groups. Effective akinesia and mydriasis were observed in all groups. The (TOF) was 0.9 in all groups. Throughout the study was observed in group LC a shortened onset of akinesia and a prolonging its duration. The peribulbar injection of cisatracurium and levobupivacaine provided effective akinesia and mydriasis, and shortened the onset of akinesia while prolonging its duration.

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Dexmedetomidine addition to local anesthetic mixture for peribulbar anesthesia in strabismus surgery

Gabr,

Badry,

Rabea

2024

Journal of the Egyptian Ophthalmological Society

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Aim To evaluate the effect of the addition of dexmedetomidine to the local anesthetic mixture for peribulbar anesthesia in strabismus surgeries. Methods A randomized controlled study included 58 patients who were divided into two groups, group І: included 29 patients who received peribulbar block by a mixture of local anesthetics only, and group II: included 29 patients who received peribulbar block by a mixture of local anesthetics with dexmedetomidine. All cases underwent preoperative full ophthalmic examination. The onset and duration of sensory block, onset and duration of motor block, hemodynamic parameters, sedation level, and duration of analgesia were assessed. Results The onset of sensory and motor block was shortened (P =0.021 and <0.001, respectively) and their duration was prolonged (P <0.001) and the duration of postoperative analgesia was significantly longer in the dexmedetomidine group (P <0.001). Dexmedetomidine group achieved higher sedation scores and lower intra and early postoperative pain scores (P 0.001 and <0.001, respectively) with higher levels of patient and surgeon satisfaction. Conclusion The addition of dexmedetomidine with the local anesthetic mixture for peribulbar anesthesia in strabismus surgeries accelerates the onset of anesthesia and akinesia of the globe and prolongs their duration. It extends the time to the first analgesic request and enhances the satisfaction of both patients and surgeons.

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Peribulbar anesthesia for strabismus surgery in adult patients

Cited by 4 publications

References 53 publications

The Effect of Adding Fentanyl to Peribulbar Block on Muscle Traction during Squint and Buckle Surgeries in Adult Patients: A Randomized Controlled Trial

The Effect of Adding Fentanyl to Peribulbar Block on Muscle Traction during Squint and Buckle Surgeries in Adult Patients: A Randomized Controlled Trial

Levobupivacaine Combined with Cisatracurium in Peribulbar Anaesthesia in Cats Undergoing Corneal and Lens Surgery

Dexmedetomidine addition to local anesthetic mixture for peribulbar anesthesia in strabismus surgery

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