Postoperative analgesia of ultra-low-dose naloxone versus dexmedetomidine with local anesthetic in peribulbar block in cataract surgery

2018 ◽  
Vol 16 (3) ◽  
pp. 314
Author(s):  
AhmedM.M El-Garhy ◽  
NourE.A.H.A Halim
Keyword(s):  
Cataract Surgery ◽  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Low Dose ◽  
Peribulbar Block

scholarly journals Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 67-68
Author(s):  
Abdul Nasser ◽  
Faheem Raja
Keyword(s):  
Case Report ◽  
Cataract Surgery ◽  
Local Anesthetic ◽  
Lipid Emulsion ◽  
Early Recognition ◽  
Systemic Toxicity ◽  
Peribulbar Block ◽  
Local Anesthetic Systemic Toxicity ◽  
Symptoms And Signs

ABSTRACT Cataract surgery is performed routinely under regional orbital blocks including retrobulbar and peribulbar blocks. Several complications have been reported while performing these blocks, the most significant of which is the local anesthetic systemic toxicity (LAST). The symptoms and signs present in a varied spectrum, but every such case requires early recognition and immediate resuscitation to avoid long-term morbidity and even death. Lipid emulsion therapy forms the mainstay of treatment. We present a case of a 49-year-old man who planned to undergo cataract surgery under the peribulbar block, who developed LAST and was successfully treated with 20% lipid emulsion without any adverse sequelae. How to cite this article Nasser A, Raja F. Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report. J Med Acad 2020;3(2):67–68.

scholarly journals Comparing different fentanyl concentrations added to local anesthetic mixture in peribulbar block for cataract surgery

2016 ◽  
Vol 32 (2) ◽  
pp. 189-193 ◽  
Author(s):  
Inas Kamel ◽  
Ashraf Mounir ◽  
Ahmed Zaghloul Fouad ◽  
Hany Mekawy ◽  
Ehab Bakery
Keyword(s):  
Cataract Surgery ◽  
Local Anesthetic ◽  
Peribulbar Block

scholarly journals Fentanyl versus midazolam as additive to local anesthetic mixture for peribulbar block during posterior segment surgery in adult patients a prospective randomized double-blind study

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Ahmed Abdalla Mohamed ◽  
Tamer Fayez Safan
Keyword(s):  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Posterior Segment ◽  
Adult Patients ◽  
The Other ◽  
Control Group ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Number Of Patients ◽  
Peribulbar Block

Abstract Objectives To evaluate analgesic and hemodynamic outcome of fentanyl or midazolam as additives to local anesthetic mixture (LAM) for peribulbar block (PBB) during posterior chamber surgery. Methods One hundred thirty-two ASA status I to III adult patients aged 50–75 years scheduled for posterior segment surgery (intraocular foreign body and elective vitrectomy) were enrolled in this prospective, randomized, double-blind trial from which 12 patients were excluded. After signing a written fully informed consent for study participation, patients were grouped into 3 groups (40 patients in each group); group C received local anesthetic mixture plus 1 ml plain saline, group F received local anesthetic mixture plus 25 μg fentanyl in 1 ml saline and group M received local anesthetic mixture plus 1 mg midazolam in 1 ml saline. The primary outcome was the onset time of eyelid and globe akinesia. Also, the duration of the block was assessed in the three studied groups. Intraoperative and postoperative hemodynamic measures were assessed. Postoperative analgesia was hourly-assessed using Visual analogue scale (VAS) and rescue analgesia was provided at visual analogue score of > 3. Results The number of patients who had fast eyelid and globe akinesia was significantly higher with significantly lower total 15-min score in group F than the other groups. Intraoperative and postoperative hemodynamic measures were non-significantly different between studied groups. Duration of the block was significantly longer in groups F and M than group C with significantly longer duration in group F. The number of patients who required postoperative rescue analgesia was significantly lower with significantly lower number of requests in group F than the other groups. Conclusion Additives to local anesthetic mixture during peribulbar block provided satisfactory anesthetic outcome than local anesthetic mixture alone. Fentanyl was superior to midazolam in terms of significantly speed up onset, longer block duration with significantly longer postoperative analgesia and lesser consumption of rescue analgesia. Both additives provided adjusted hemodynamic measures comparable to the control group. Trial registration Pan African Clinical Trials Registry (PACTR201708002496243) registered 03/08/2017 retrospectively.

EFFECT OF USING FENTANYL AS AN ADDITIVE WITH THE LOCAL ANAESTHESTIC MIXTURE IN PERIBULBAR BLOCK FOR CATARACT SURGERIESA PROSPECTIVE RANDOMIZED CONTROL STUDY

2021 ◽  
pp. 5-7
Author(s):  
M.Selvi Annie Geeta ◽  
Lakshmi K.Nair
Keyword(s):  
Blood Pressure ◽  
Cataract Surgery ◽  
Respiratory Rate ◽  
Pulse Rate ◽  
Local Anesthetic ◽  
Sensory Blockade ◽  
Vas Score ◽  
Department Of Ophthalmology ◽  
Peribulbar Block ◽  
The Mean

INTRODUCTION: Cataract surgery is one of the most commonly performed surgery in the elderly patients. Regional anesthesia is safe, reliable, provide adequate akinesia and analgesia of the eye, a good postoperative pain relief and a shorter hospital stay. The various regional anesthetic techniques used in ophthalmic surgeries are peribulbar block, retrobulbar block, sub tenon's block, subconjunctival block and topical corneo-conjunctival anesthesia. Due to its safer approach, the peribulbar block is most commonly. Addition of an opioid like fentanyl to the anesthetic preparation will provide a faster onset of lid and globe akinesia, faster onset of sensory blockade, increase the duration of analgesia and reduce the need for rescue analgesia postoperatively. AIM OF THE STUDY: To evaluate the effect of addition of fentanyl to the local anesthetic mixture in peribulbar block in cataract surgery. MATERIALS AND METHODS: This study was done in the Department of Anesthesiology in collaboration with the Department of Ophthalmology in Kanyakumari Government Medical College from January 2019 to December 2019. Patient posted for cataract surgery were allocated into two groups by randomization (30 each). Group S – 4ml of 2% lignocaine with adrenaline premixed with hyaluronidase + 1ml of 0.5% Bupivacaine + 0.5ml normal saline. Group F – 4ml of 2% lignocaine with adrenaline premixed with hyaluronidase + 1ml of 0.5% Bupivacaine + 25 mcg Fentanyl (0.5 ml). The Parameters related to the study such as Onset of lid akinesia, Onset of globe akinesia, Onset of sensory blockade, Duration of analgesia by VAS score, Level of sedation by Ramsay sedation score, vital parameters – SpO , pulse rate, respiratory rate, blood pressure and any 2 Complications were recorded. RESULTS: We found that the demographic parameters were comparable and statistically insignicant. The preoperative hemodynamic parameters like the systolic and diastolic blood pressure, pulse rate, SpO2, respiratory rate were statistically insignicant and comparable. The mean onset of lid akinesia was 5.8 ± 1.76 mins and 3.13 ± 1.25 mins in Group S and Group F respectively. The mean onset of globe akinesia was found to be 7.46 ± 2.22 mins and 4.2 ± 1.60 mins in Group S and Group F respectively. The mean onset of sensory blockade was 6.8 ± 1.24 mins and 4.93 ± 1.63 mins in Group S and Groups F respectively. Thus the onset of globe and lid akinesia and the onset of sensory blockade was faster in Group F compared to Group S. The mean VAS scores were statistically signicant (P<0.001) between both the groups at 1 hour, 1.5 hour, 2 hour, 4 hour, 6 hour postoperatively and it was found that Group F has a lower VAS score when compared with Group S. The VAS score at 8 hour and 10 hours postoperatively were statistically insignicant (p>0.05) in both the groups. The mean duration of analgesia was 4.56 ± 1.65 hours in Group S and 7.63 ± 2.55 hours in Group F and was found to be statistically signicant(P<0.001). CONCLUSION: Based on this study, we can conclude that there is a faster onset in the lid akinesia, globe akinesia, in the onset of sensory blockade and a substantial increase in the duration of analgesia when fentanyl is used as an additive along with the local anesthetic mixture in peribulbar block for cataract surgery

Addition of Fentanyl to Hyperbaric Bupivacaine in spinal anesthesia for Caesarian section – effect on dose of local anesthetic and duration of postoperative analgesia – a randomized comparative study

JMS SKIMS ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 62-68
Author(s):  
Ghulam Mohammed Mir ◽  
Mohammed Abdul Haadi
Keyword(s):  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Low Dose ◽  
Caesarian Section ◽  
Sensory Level ◽  
Hyperbaric Bupivacaine ◽  
Group I ◽  
Low Incidence ◽  
Fentanyl Group

Background: Spinal anesthesia is commonly used for caesarian section for its reliability and ease of administration. However, it is limited by fixed duration of anesthesia, hypotension and lesser control of block height. The combination of reduced dose of local anesthetic agent with intrathecal opioid makes it possible to achieve adequate spinal anesthesia with minimum hypotension and prolonged postoperative analgesia. The study aims to monitor the effect of intrathecal fentanyl and bupivacaine on reduction of higher blocks and simultaneously improving the quality and avoiding higher doses of local anesthesia agents. Methods: Forty patients scheduled for elective caesarian section were divided in to two groups of twenty each. Group I patients received Bupivacaine 12.5 mg (0.5%) for spinal anesthesia and group II patients received combination of Bupivacaine 8.5 mg (0.5%) with fentanyl 25 mcg. Patients were observed for hypotension, bradycardia, nausea, pruritus, quality of surgical anesthesia and duration of postoperative analgesia. Results: All the patients had adequate surgical anesthesia for the procedure and in no patient conversion to general anesthesia was required. Peak sensory level was higher (T2-T3 vs T4-T6) and motor block was more intense in the regular dose bupivacaine group of patients. More patients in bupivacaine only group developed hypotension and the requirement of vasopressors was significantly higher than the low dose bupivacaine with fentanyl group. Also the Visual analogue scale score for pain was less in the bupivacaine-fentanyl group, who received less postoperative analgesics for first twelve hours. Conclusions:  We conclude that combination of low dose bupivacaine (8.5mg) with fentanyl provides adequate surgical anesthesia for caesarian section and with low incidence of hypotension and nausea. Also, addition of fentanyl helps in prolongation of postoperative analgesia. JMS 2017;20(2):62-68

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