This study aims to compare the hemodynamic effect of dexmedetomidine and magnesium sulphate as an adjuvant to lidocaine in preemptive peribulbar block in patients undergoing Dacryocystorhinostomy (DCR) under general anaesthesia (GA) .
Dacryocystorhinostomy (DCR) is a delicate ophthalmic surgical procedure aimed at reestablishing the patency of the nasolacrimal duct in patients suffering from nasolacrimal duct obstruction (NLDO). Magnesium is a non-competitive N-methyl-D-aspartate (NMDA) receptors antagonist, and it can decrease the excitatory post synaptic currents produced by activation of NMDA receptors and it inhibits voltage gated calcium channels. Dexmedetomidine alpha-2 agonist, which stimulates both central and peripheral alpha-2 receptors which inhibits neuronal firing and inhibits release of C-fibers transmitters such as norepinephrine which inhibits nerve fiber action potential and explains the antinociceptive effects of dexmedetomidine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
Patients will receive 5 ml of lidocaine 2% + 50 µg dexmedetomidine, with a total volume of 7 ml.
Patients will receive 5 ml of lidocaine 2% + 100 mg magnesium sulphate 10%, with a total volume of 7 ml.
Patients will receive 7 ml of lidocaine 2% with no further additives.
Cairo University
Cairo, Egypt
RECRUITINGChange in mean arterial blood pressure
The change in mean arterial blood pressure will be recorded at baseline, after induction of anesthesia, immediately before peribulbar block, after block administration, at skin incision, during osteotomy and lacrimal sac manipulation (oculocardiac reflexes-provoking steps), and every 5 minutes thereafter until the end of surgery.
Time frame: Till the end of surgery (Up to 2 hours)
Heart rate
Heart rate will be recorded at baseline, after induction of anesthesia, immediately before peribulbar block, after block administration, at skin incision, during osteotomy and lacrimal sac manipulation (oculocardiac reflexes-provoking steps), and every 5 minutes thereafter until the end of surgery.
Time frame: Till the end of surgery (Up to 2 hours)
Oxygen saturation
Oxygen saturation will be recorded at baseline, after induction of anesthesia, immediately before peribulbar block, after block administration, at skin incision, during osteotomy and lacrimal sac manipulation (oculocardiac reflexes-provoking steps), and every 5 minutes thereafter until the end of surgery.
Time frame: Till the end of surgery (Up to 2 hours)
Degree of patient satisfaction
Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied)
Time frame: 24 hours postoperatively
Degree of surgeon satisfaction
Degree of surgeon satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied)
Time frame: 24 hours postoperatively
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