scholarly journals Magnesium sulphate versus dexmedetomidine as an adjuvant to local anesthetic mixture in peribulbar anesthesia

2017 ◽  
Vol 33 (4) ◽  
pp. 375-380 ◽  
Author(s):  
Ahmed Zein Elabdein Mohamed ◽  
Mahmoud Mohamed Genidy
Keyword(s):  
Local Anesthetic ◽  
Magnesium Sulphate ◽  
Peribulbar Anesthesia

scholarly journals Efficacy and Safety of Magnesium versus Dexmedetomidine as Additives to Local Anesthetic Mixture Using Single Injection Percutaneous Peribulbar Anesthesia in Vitreoretinal Surgeries

2018 ◽  
Vol 12 (1) ◽  
pp. 94-100
Author(s):  
Aktham Shoukry ◽  
Amr Sobhy Abd el Kawy
Keyword(s):  
Local Anesthetic ◽  
Normal Saline ◽  
Magnesium Sulphate ◽  
Motor Block ◽  
Vitreoretinal Surgery ◽  
Control Group ◽  
Peribulbar Block ◽  
Ocular Pressure ◽  
Peribulbar Anesthesia ◽  
Group D

Background: Peribulbar block for vitreoretinal surgery is rather associated with delayed onset of globe anesthesia, akinesia and short duration of analgesia. Objective: To compare the effect of addition of Magnesium sulphate vs dexmedetomidine to standard local anesthetics mixtures on the time of onset of Globe Anesthesia, Akinesia & analgesia duration. Patients and Methods: Ninety patients of both sexes, aged 25- 75 years, ASA I-III scheduled for vitreoretinal surgery. They were randomly allocated into 3 equal groups each received peribulbar block a mixture of Levo- bupivacaine 0.5% (3 ml) + lidocaine 2% (3 ml) +120 IU hyaluronidase + Control group (C): 0.5 ml of Normal saline. Group (M): 50 mg of Magnesium sulphate in 0.5 ml normal saline. Group (D): 50 μic of dexmedetomidine in 0.5 ml normal saline. The duration of sensory, motor block, Sedation level, Intra-ocular Pressure (IOP) and surgeon satisfaction were assessed. Results: The onset of globe anesthesia and akinesia was significantly shorter in M group in comparison with D and C Groups, with a significant increase in the duration of globe analgesia and akinesia in the D Group when compared to both M & C groups. Groups D and M showed a statistically significant decrease in the IOP at 5 min and 10 min when compared to the baseline measurement of the same groups & to C Group, no complications or adverse effects related to the drug or technique were recorded. Conclusion: Magnesium sulphate as a local anesthetic adjuvant in peribulbar block is safe and comparable to dexmedetomidine regarding the sensory and motor block duration with better cost-effectiveness and availability.

scholarly journals Effectiveness and Safety of Single Percutaneous Peribulbar Block Using Magnesium Sulphate as an Adjuvant to Local Anesthetics Versus the Standard Peribulbar Block for Strabismus Surgery in Adults

2019 ◽  
Vol 13 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Norhan Aly Sherif ◽  
Mayada Khairy Mohamad ◽  
Sameh Galal Taher ◽  
Ahmed Abdou Hannon ◽  
Hesham Mohamed Salem
Keyword(s):  
Magnesium Sulphate ◽  
Local Anesthetics ◽  
Strabismus Surgery ◽  
Patient’S Satisfaction ◽  
Group I ◽  
Peribulbar Block ◽  
Peribulbar Anesthesia ◽  
Adult Strabismus ◽  
Group Ii

Background: Peribulbar anesthesia in ophthalmic surgeries is limited by delayed and/or incomplete orbital akinesia and inadequate operative and postoperative analgesia. Objective: The aim of this study was to assess the safety and effectiveness of a single percutaneous peribulbar block technique with 100 mg magnesium sulphate added to the local anesthetics used compared with the standard peribulbar block technique in adult strabismus surgery. Methods: A total of 54 consecutive patients undergoing strabismus surgery were included in the study. They were divided into two equal groups (27 patients each). In group I, 1 ml (100 mg/ml) magnesium sulphate added to a mixture of 2 ml lidocaine 2%, 2 ml bupivacaine 0.5% and 1 ml hyaluronidase (150 units/ml) was administered through a single percutaneous peribulbar injection with a short (1 inch) needle, while in group II, a mixture of 1 ml saline added to 2 ml lidocaine 2%, 2 ml bupivacaine 0.5% and 1 ml hyaluronidase (150 units/ml) was administered using the standard peribulbar block technique. The collected data included patient's baseline characteristics, perioperative and early postoperative outcomes and follow-up data. Results: The elapsed time before the onset of anesthesia and akinesia of the globe was significantly shorter in group I compared with group II (1.9 ± 0.7 vs. 3.9 ± 1.0 min, p < 0.001; 2.3 ± 0.7 vs. 4.4 ± 1.2 min, p < 0.001 respectively), and the duration of anesthesia was significantly longer in group I compared with group II (180.0 ± 0.0 vs. 43.0 ± 8.5 min, p < 0.001). The median VAS pain score was significantly lower in group I compared with group II (1.0 vs. 4.0, p < 0.001), and the patient's satisfaction was significantly higher in group I compared with group II (100.0% vs. 25.9%, p < 0.001). Conclusion: Co-administration of 100 mg magnesium sulphate with the local anesthetics was effective and safe. It achieved suitable conditions to start surgery rapidly. Further, it improved the quality of operative conditions and patient satisfaction.

Peribulbar versus  Retrobulbar Anesthesia for Ophthalmic Surgery

2001 ◽  
Vol 94 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Jacques Ripart ◽  
Jean-Yves Lefrant ◽  
Jean-Emmanuel de La Coussaye ◽  
Dominique Prat-Pradal ◽  
Bruno Vivien ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Local Anesthetic ◽  
Clinical Studies ◽  
The Other ◽  
Ophthalmic Surgery ◽  
Retrobulbar Anesthesia ◽  
Thin Slices ◽  
Human Cadavers ◽  
Peribulbar Anesthesia

Background Peribulbar and retrobulbar anesthesia have long been opposed on the basis of the existence of an intermuscular membrane, which is supposed to separate the intraconal from the extraconal spaces in a water-tight fashion. A local anesthetic injected outside the cone should spread through this septum to reach the nerves to be blocked. The existence of this septum is questioned. The aim of this study was to compare the spread of a colored latex dye injected intraconally or extraconally to simulate both retrobulbar and peribulbar anesthesia. Methods The authors used 10 heads from human cadavers. For each head, one eye was injected intraconally, and the other eye was injected extraconally. The heads were then frozen and sectioned into thin slices following various planes. They were then photographed and observed. Results There was no evidence of the existence of an intermuscular septum separating the intraconal and extraconal spaces. Those two spaces appeared to be part of a common spreading space, the corpus adiposum of the orbit. Conclusions These results are in accord with the fact that clinical studies were not able to clearly demonstrate that retrobulbar anesthesia is more efficient than peribulbar anesthesia. On the basis of a similar clinical efficacy of the two techniques as a result of similar spreading of the local anesthetic injected, and a potentially higher risk of introducing the needle into the muscular cone, the authors recommend replacing retrobulbar anesthesia with peribulbar anesthesia.

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