Single injection peribulbar anaesthesia

Abstract

SummaryA prospective, observer blinded study on 51 patients undergoing cataract surgery was conducted to assess Total Upper Eyelid Drop as a new end-point marker to single injection peribulbar block. At present, no such clinical marker exists to stop clinicians injecting more than necessary volumes of local anaesthetic and therefore to prevent dangerous increases in intra-ocular pressure. Using this technique, satisfactory ocular akinesia was achieved in 90% of eyes 10 min after injection. Operating conditions were satisfactory in 98% of cases. The mean (range) volume injected was 9.1 (4±15) ml. The mean increase in intra-ocular pressure immediately after injection was 6.9 mmHg, decreasing to 0.7 mmHg after 5 min without the application of ocular compression. We found a negative correlation between the increase in intra-ocular pressure and the volume of injection (p , 0.002), which has never previously been reported. We conclude that Total Upper Eyelid Drop is a reliable endpoint marker for producing satisfactory operating conditions for cataract surgery while minimising increases in intra-ocular pressure and its use may therefore avoid the risks associated with ocular compression.

The effect on outcome of peribulbar anaesthesia in conjunction with general anesthesia for vitreoretinal surgery

“…Akinesia was evaluated in the four quadrants using a 3-point scoring system: 0 = akinesia; 1 = partial akinesia; and 2 = normal movement, giving a maximal score of eight for the four muscles. An akinesia score of three or less was defined as a successful block [8]. Sensory block was assessed according to abolition of the corneal reflex and the eye was dressed until induction of anaesthesia.…”

Outcome Values of Adding Sodium Bicarbonate, Dexamethasone and Fentanyl to Local Anesthetic in Peribulbar Block during Vitreoretinal Surgeries. A Randomized Prospective Study

“…0 = no movement at all, 1 = partial movement in one or two directions, 2 = free movement in all directions giving an aggregated score ranging from zero to 8 for the 4 direction. The block will be considered to be satisfactory when global akinesia score of 3 or less not more than 1 in each direction [9].…”

Dexmedetomidine vs. Fentanyl as Adjuvant to Local Anaesthetic Mixture in Peribulbar Block for Retinal Surgery: A Randomized Prospective Study

“…Successful block was defined as an akinesia score of 3 or less (not more than 1 in each direction) [9]. Three to five ml of local anaesthetic mixture (Supplementary anaesthesia) was injected either superiorly (if the movement was lateral or superior)or medially (if the movement was medial or inferior) if the motor blockade was inadequate after 10 min of the block and the total volume of local anesthetic solution injected (mL) was calculated.…”