50 patients of both sexes, ages 18 to 75, who were scheduled for cataract surgery and had physical status I or II according to the American Society of Anesthesiologists were included in this study. After induction of general anesthesia, all patients received peribulbar block. In group A (midazolam group), 25 patients received midazolam. In group B (dexmedetomidine group), 25 patients received dexmedetomidine.
Background: Peribulbar blocks are commonly used for cataract surgery, providing effective anesthesia with reduced recovery time. The addition of sedative agents, such as dexmedetomidine or midazolam, may enhance the anesthetic effect and patient comfort while maintaining hemodynamic stability. However, the optimal sedative agent for use in this context remains uncertain. Objective: This study aimed to compare the efficacy and safety of dexmedetomidine and midazolam as adjuvants to local anesthetic in peribulbar blocks for cataract surgery. Methods: A randomized, double-blind clinical trial included 50 patients aged 18-75 years with the American Society of Anesthesiologists physical status I-II who were scheduled for cataract surgery under peribulbar block. Participants were randomly allocated to two groups: Group A received midazolam (1 mg), and Group B received dexmedetomidine (50 µg), combined with a standard mixture of local anesthetics. The primary outcomes included the onset and duration of motor and sensory block and lid akinesia. Secondary outcomes assessed the quality of motor and sensory block, lid akinesia using the Ocular Anesthesia Scoring System, sedation levels using the Ramsay Sedation Score, the occurrence of local or systemic complications, and satisfaction levels reported by both patients and surgeons. Keywords: dexmedetomidine; midazolam; peribulbar block; cataract surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
Dexmedetomidine as an adjuvant to a local anesthetic mixture (bupivacaine, lidocaine, and hyaluronidase) for peribulbar block during cataract surgery
Midazolam as an adjuvant to a local anesthetic mixture (bupivacaine, lidocaine, and hyaluronidase) for peribulbar block during cataract surgery
Suez canal university
Ismailia, Egypt
onset of motor block
The period of time that passed after the local anesthetic mixture was injected before the eye globe was completely immobile
Time frame: Intraoperative from the moment of local anesthesia injection until the moment of complete and full globe akinesia up to 1 hour
onset of sensory block
the period of time following the local anesthetic mixture injection that resulted in total insensitivity and absent eye reflexes
Time frame: Intraoperative from the moment of local anesthesia injection until the moment of complete insensitivity and absent reflexes of the eye up to 1 hour
length of the motor block
The time it takes for the entire eye globe to return to free motion after experiencing akinesia
Time frame: Periperative from the moment of complete and full globe akinesia until the moment of return back of eye movement up to 1 hour
length of the sensory block
The amount of time before the entire eye globe regains sensation after experiencing insensitivity and areflexia andreflexes
Time frame: Periperative from the moment of complete areflexia until the moment of return back of sensation and reflexes up to 1 hour
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