The aim of this study is to compare efficacy of dexmedetomidine as an additive to topical versus peribulbar anesthesia for cataract surgery
Ocular surgery may be performed under topical, regional, or general anesthesia. The first recorded use of regional anesthesia for surgery was the instillation of cocaine into the conjunctival sac in 1884 by an Austrian ophthalmologist. Davis and Mandel in 1986 described the peribulbar block, peribulbar block has delayed onset and need a higher volume of local anesthetic (LA) than a retrobulbar block. But the peribulbar block is away from intra-conal space and so produce fewer complication. Dexmedetomidine is used as adjuvant to LA drugs in peripheral nerve block, brachial plexus block and intrathecal anesthesia with satisfactory results. A more recent study using dexmedetomidine (50 μg) with the peribulbar block before cataract surgery demonstrated an IOP decrease similar to IV dexmedetomidine administration and greater than a peribulbar block without dexmedetomidine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
94
Patients will receive mixture of one milliliter of dexmedetomidine-HCl and local anesthetic
Patients will receive mixture of bupivacaine 0.5% (4.5 ml) + lidocaine 2% (4.5 ml) + dexmedetomidine 50 μg (1 ml) in peribulbar block
Mohammed Fouad Mohamed Algyar
Kafr ash Shaykh, Kafrelsheikh, Egypt
RECRUITINGInadvertent eye movement
Asses intra-ocular pressure (IOP) before injection of baseline and after a complete akinesia of the globe before surgical incision.
Time frame: 2 hours postoperatively
Anesthesia-related complications
The patients will be asked whether the cataract surgery was more or less painful than having the needle used for intravenous infusions inserted into the back of the hand.
Time frame: 2 hours postoperatively
Sedation level
Numeric Rating Scale will be applied to grade the pain where 0 = no pain and 10 = extreme pain.
Time frame: 2 hours postoperatively
pain during and after the surgery
Immediately after surgery, patients will be asked to grade the pain felt during the operation, including the pain felt after delivery of topical or peribulbar anaesthesia.
Time frame: 2 hours postoperatively
Need for additional anesthesia during surgery and surgeon
The dose of additional needed anesthesia (fentanyl 0.5 µg/kg) during surgery will be recorded
Time frame: During surgery
Intraoperative difficulties
The surgeon will also be requested to grade any difficulties encountered during surgery immediately after the operation, using a 4-point scale, where 1 = no difficulty and 4 = extremely difficult
Time frame: 2 hours postoperatively
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