Comparing General Anesthesia with Preemptive IV Atropine vs General Anesthesia with Single Injection Peribulbar Block with Levobupivacaine 0.5% or Lidocaine 2% for Prevention of Oculocardiac Reflex in Children Undergoing Strabismus Surgery: Randomized Control Study

Abstract Background Strabismus is one of the common health problems among the children. The incidence of the oculocardiac reflex decreases with age and tends to be more pronounced in young, healthy patients, which is clinically significant for pediatric as it is observed with greatest incidence in young healthy neonates and infants undergoing strabismus surgery. Objective to prevent and attenuate the oculocardiac reflex in children age group from (2yrs to 14 yrs) undergoing surgical correction for strabismus. Patients and Methods Three groups were allocated Group C received general anaesthesia combined with pre emptive atropine, Group L received general anaesthesia combined with Peribulbar block with Lidocaine 2 % and Group LB which received general anaesthesia combined with peribulbar block with Levobupivacaine 0.5%. Results In Our study we found that group L which received peribulbar lidocaine 2 % was the most successful group regarding blocking the occurrence of the OCR and with acceptable post operative pain control results. Conclusion In Our study the use of peribulbar block with lidocaine 2 % in combinations with General anaesthesia is very effective against the incidence of OCR in children undergoing strabismus surgery and superior to the Iv pre emptive Atropine with higher surgeon satisfaction while the use of peribulbar levobupivacaine 0.5% combined with general anaesthesia has a great role in post operative pain control with superior patient satisfaction, on the other hand the atropine is a very important emergency drug but our study found that it has a very minor role in both preventing the OCR and post operative pain control in addition to subjecting the patients to the tachycardia and other complications like dryness of the mouth and blushing so its not recommended by our study.

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08 / Peribulbar block vs. general anaesthesia for corneal transplantation: analgesic requirements and pain control

10.26226/morressier.5aeb0ac707b0d6001a79a2ed ◽

2018 ◽

Author(s):

João Xavier ◽

Gabriela Gonçalves

Keyword(s):

General Anaesthesia ◽

Pain Control ◽

Corneal Transplantation ◽

Peribulbar Block

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Peribulbar anesthesia for strabismus surgery in adult patients

European Journal of Ophthalmology ◽

10.1177/1120672120974947 ◽

2020 ◽

pp. 112067212097494

Author(s):

Aldo Vagge ◽

Franco Simonetti ◽

Maria Marenco ◽

Carmen Burtolo ◽

Maria Musolino ◽

...

Keyword(s):

Visual Acuity ◽

Medical Records ◽

Strabismus Surgery ◽

Adult Patients ◽

Study Group ◽

Efficacy And Safety ◽

Oculocardiac Reflex ◽

Peribulbar Block ◽

Peribulbar Anesthesia ◽

Intravenous Atropine

Purpose: To evaluate the efficacy and safety of peribulbar anesthesia during strabismus surgery. Methods: Medical records of patients undergoing strabismus surgery and peribulbar anesthesia were reviewed. The overall efficacy of peribulbar anesthesia was evaluated as requirement of supplemental peribulbar anesthesia, impossibility to perform eye muscles surgery due to inadequate efficacy of the block and peribulbar block complications that occurred up to 6 weeks postoperatively. Presence of oculocardiac reflex (OCR) and presence of decreased visual acuity and afferent pupillary defect postoperatively were reported. Results: A total of 510 patients comprised our study group. The total amount of peribulbar injections was 717. Four patients (0.7%) required supplemental injection in the superonasal quadrant. Five of 510 (0.9%) required an anesthesiologic intervention with intravenous atropine. Eighty patients of 510 (15.6%) complained about transitory complete ptosis and/or amaurosis postoperatively. No complications were observed up to 6 weeks postoperatively. Conclusion: Peribulbar anesthesia was an effective and safe option during strabismus surgery in adult patients.

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Tumescent Local Anesthesia: A Systematic Review of Outcomes

10.1101/2020.08.10.20170720 ◽

2020 ◽

Author(s):

Yu Liu ◽

Sanjana Lyengar ◽

Chrysalyne D Schmults ◽

Emily S Ruiz ◽

Robert Besaw ◽

...

Keyword(s):

Systematic Review ◽

General Anesthesia ◽

Local Anesthesia ◽

Surgical Procedures ◽

Pain Control ◽

Case Series ◽

Intravenous Sedation ◽

Tumescent Local Anesthesia ◽

Complication Risk ◽

Post Operative Pain

IMPORTANCE: Tumescent local anesthesia (TLA, whereby anesthesia is achieved by injection of a highly diluted solution of local anesthesia into skin and subcutaneous tissues) is a technique for delivering anesthesia for superficial surgical procedures. TLA obviates the need for general anesthesia or intravenous sedation in most cases. Pain control and TLA-related complications are key factors in determining the success of TLA. OBJECTIVE: To conduct a systematic review of the English medical literature data regarding pain control and TLA-related complications in TLA surgical cases to determine its efficacy and safety EVIDENCE REVIEW: The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Searches of both the MEDLINE and EMBASE databases were performed. Articles using 10-point quantitative scales were included in the pain analysis. Complications were tabulated from cohort studies, case series, and case reports. A total of 184 articles cotaining reports of 71,483 surgical procedures met inclusion criteria, including 43 with pain outcomes and 141 reporting complications. FINDINGS: Liposuction procedures were associated with relatively low degree of both intra-operative pain (10-point visual analog scale 1.1 +/- 2.1) and post-operative pain (0.53 +/- 0.44) and the fewest complications (1.2%). The highest intra-operative and post-operative pain was reported in facial/cleft-lip surgery (3.7 and 3.99, respectively), while mastectomy was associated with highest post-operative complication risk (20.8%). There were 8 reported cases of death unlikely related to TLA: pulmonary embolus (4 cases), complications related to concurrent general anesthesia (2 cases), hemorrhage, and visceral perforation. There were 5 reported cases of death related to TLA (lidocaine/bupivacaine toxicity in 4 cases and one case of fluid overload) during its development when optimal dose and volume parameters were being established. There have been no TLA-associated deaths reported in the 33,429 cases published since 2003. CONCLUSIONS AND RELEVANCE This systematic review demonstrates TLA to be a safe and effective anesthetic approach. Its low-cost and rapid patient recovery warrant further studies of cost-reduction and patient satisfaction. Expanded education of TLA techniques in surgical and anesthesia training programs may be considered to broaden patient access to this anesthetic modality for cutaneous and subcutaneous surgical procedures.

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Effect of topical or peribulbar analgesia on the incidence of oculocardiac reflex, postoperative pain and postoperative nausea and vomiting following vitreoretinal surgery under surgical pleth index-guided general anaesthesia.

10.21203/rs.2.13337/v1 ◽

2019 ◽

Author(s):

Michal J Stasiowski ◽

Aleksandra Pluta ◽

Anita Lyssek-Boron ◽

Izabela Szumera ◽

Malgorzata Pieta ◽

...

Keyword(s):

General Anaesthesia ◽

Postoperative Nausea ◽

Pain Perception ◽

Vitreoretinal Surgery ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Perioperative Outcomes ◽

Topical Anaesthesia ◽

Oculocardiac Reflex ◽

Peribulbar Block

Abstract Background: Despite of the risk of postoperative intolerable pain perception (PIPP), vitreoretinal surgery (VRS) requires general anaesthesia (GA) in selected patients. Intraoperative use of opioid analgesics (OA) during GA carries the risk of postoperative nausea and vomiting (PONV). The surgical pleth index (SPI) optimises the intraoperative titration of OA. Regional anaesthesia techniques are combined with GA to minimize the intraoperative use of OA. We evaluated the benefit of preventive analgesia techniques combined with GA using SPI-guided fentanyl (FNT) administration on the incidence of PONV, oculocardiac reflex (OCR) and PIPP in patients undergoing VRS. Methods: One hundred and five patients undergoing VRS were randomly allocated to receive either GA with SPI-guided fentanyl (FNT) administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group) or preoperative peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group). Fifteen patients were excluded due to problems with postoperative SPI measurement. Results: Preventive PBB resulted in intraoperative reduction in FNT requirement, with no influence on perioperative outcomes. Intraoperative SPI-guided FNT administration during GA resulted in OCR in 7.78%, PONV in 10% and PIPP in 13.5% of patients undergoing VRS. Intraoperative SPI-guided FNT administration blunted the perioperative effect of preventive PBB and TA in terms of the presence of PONV, OCR and PIPP.Conclusions: The utility of SPI-guided FNT administration during GA eliminated benefits of preventive analgesia with PBB and TA following VRS. We recommend using intraoperative SPI-guided FNT administration during GA to reduce the presence of OCR, PONV and PIPP following VRS. Trial registration: The trial was approved and registered by The Ethical Committee of Medical University of Silesia on 29th of September 2015, as well as the project was registered in the Clinical Trial Registry (SilesianMUKOAiIT2, NCT02973581)Key words: vitreoretineal surgery, general anaesthesia, peribulbar block, topical anaesthesia, surgical pleth index.

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A prospective randomised double blind study to evaluate the effect of peribulbar block or topical application of local anaesthesia combined with general anaesthesia on intra-operative and postoperative complications during paediatric strabismus surgery

Anaesthesia ◽

10.1111/j.1365-2044.2007.05220.x ◽

2007 ◽

Vol 62 (11) ◽

pp. 1110-1113 ◽

Cited By ~ 38

Author(s):

N. Gupta ◽

R. Kumar ◽

S. Kumar ◽

R. Sehgal ◽

K. R. Sharma

Keyword(s):

Postoperative Complications ◽

General Anaesthesia ◽

Topical Application ◽

Local Anaesthesia ◽

Strabismus Surgery ◽

Blind Study ◽

Double Blind Study ◽

Double Blind ◽

Peribulbar Block

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Liposomal bupivacaine inferior to indwelling interscalene nerve block for post-operative pain control in shoulder arthroplasty: a prospective randomized controlled trial

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2016.12.015 ◽

2017 ◽

Vol 26 (5) ◽

pp. e151

Author(s):

Jeffrey T. Abildgaard ◽

Keith T. Lonergan ◽

Stefan J. Tolan ◽

Michael J. Kissenberth ◽

Richard J. Hawkins ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Nerve Block ◽

Shoulder Arthroplasty ◽

Pain Control ◽

Controlled Trial ◽

Liposomal Bupivacaine ◽

Randomized Controlled ◽

Post Operative Pain ◽

Prospective Randomized Controlled Trial ◽

Interscalene Nerve Block

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Society of Family Planning clinical recommendations: Pain control in surgical abortion part 2 – moderate sedation, deep sedation, and general anesthesia

Contraception ◽

10.1016/j.contraception.2021.08.007 ◽

2021 ◽

Author(s):

Catherine Cansino ◽

Colleen Denny ◽

Sue Carlisle ◽

Phillip Stubblefield

Keyword(s):

Family Planning ◽

General Anesthesia ◽

Pain Control ◽

Deep Sedation ◽

Moderate Sedation ◽

Clinical Recommendations ◽

Surgical Abortion

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B-PO03-049 TUMESCENT LOCAL ANESTHESIA AS AN ALTERNATIVE TO GENERAL ANESTHESIA DURING SUBCUTANEOUS IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR IMPLANTATION: POST-PROCEDURAL PAIN CONTROL OUTCOMES

Heart Rhythm ◽

10.1016/j.hrthm.2021.06.524 ◽

2021 ◽

Vol 18 (8) ◽

pp. S208

Author(s):

Luigi Di Biase ◽

Dhanunjaya R. Lakkireddy ◽

Isabella Alviz ◽

David F. Briceno ◽

Abhishek K. Jaiswal ◽

...

Keyword(s):

General Anesthesia ◽

Implantable Cardioverter Defibrillator ◽

Local Anesthesia ◽

Pain Control ◽

Procedural Pain ◽

Cardioverter Defibrillator ◽

Implantable Cardioverter Defibrillator Implantation ◽

Tumescent Local Anesthesia

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Right Breast Mastectomy and Reconstruction with Tissue Expander under Thoracic Paravertebral Blocks in a 12-Week Parturient

Case Reports in Anesthesiology ◽

10.1155/2015/842725 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Christopher Allen-John Webb ◽

Paul David Weyker ◽

Shara Cohn ◽

Amanda Wheeler ◽

Jennifer Lee

Keyword(s):

Breast Cancer ◽

Postoperative Pain ◽

General Anesthesia ◽

Pain Control ◽

Breast Surgery ◽

Anesthetic Management ◽

Healthy Woman ◽

Tissue Expander ◽

Postoperative Pain Control ◽

Tissue Expanders

Paravertebral blocks are becoming increasingly utilized for breast surgery with studies showing improved postoperative pain control, decreased need for opioids, and less nausea and vomiting. We describe the anesthetic management of an otherwise healthy woman who was 12 weeks pregnant presenting for treatment of her breast cancer. For patients undergoing breast mastectomy and reconstruction with tissue expanders, paravertebral blocks offer an anesthetic alternative when general anesthesia is not desired.

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