Peribulbar anaesthesia using a combination of lidocaine, bupivocaine and clonidine in vitreoretinal surgery
<b>Purpose: </b>The efficacy and safety of peribulbar anaesthesia was assessed using a combination of lidocaine, bupivacaine and clonidine during eye surgery. <b>Methods: </b>We prospectively studied 100 vitreo-retinal surgical procedures performed by several surgeons. The ex...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2002-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2002;volume=50;issue=3;spage=205;epage=208;aulast=Calenda |
| _version_ | 1818962263153836032 |
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| author | Calenda Emile Quintyn Jean Brasseur Gerard |
| author_facet | Calenda Emile Quintyn Jean Brasseur Gerard |
| author_sort | Calenda Emile |
| collection | DOAJ |
| description | <b>Purpose: </b>The efficacy and safety of peribulbar anaesthesia was assessed using a combination of lidocaine, bupivacaine and clonidine during eye surgery. <b>Methods: </b>We prospectively studied 100 vitreo-retinal surgical procedures performed by several surgeons. The exclusion criteria included age below 30 years and, axial length of the orbit above 28 mm. Peribulbar was performed using Hamilton′s technique. A mixed anaesthetic solution of equal quantity of lidocaine 2% and bupivacaine 0.5% with clonidine (1mg/kg) was injected. Patients received a mean volume of 14.5 ml ± 3.5 of the mixture. Akinesia and analgesia were assessed 15 minutes later by the surgeon. Whenever required, supplemental lidocaine 2% (3 ml) by sub- Tenon infiltration was added by the surgeon. Supplemental injections were given only to patients who failed to develop analgesia. <b>Results: </b>The mean age of patients (male 52%, female 48%) was 66 years ± 10 (mean ± SD, range 44-90). The 100 surgical procedures were made up of vitrectomy ± gas ± silicone oil (22/100), vitrectomy and lensectomy (6/100), vitrectomy and epiretinal membrane ± laser coagulation ± gas ± silicone oil (35/100), scleral buckling or encircling ± gas (36/100), and cryosurgery ± gas (1/100). Analgesia was adequate throughout surgery without any supplementation in 85% of cases and with a sub-Tenon infiltration in 99%. Akinesia was complete in 84%, mild in 12% and absent in 4% of cases. The sub-Tenon injection was performed in 15% of cases. Three patients (3%) were agitated during surgery. No neurologic or cardiac complication was seen. In one patient, the systolic blood pressure decreased from 170 to 110 mmHg, 30 minutes after the institution of the peribulbar block. <b>Conclusion: </b>Our results show that peribulbar anaesthesia in the proposed mixture offers excellent analgesia in 85% of patients, and in 99% of the patients when supplemented by a subtenon injection. The current mixture of lidocaine, bupivacaine and clonidine is an excellent alternative to the previously used mixture etidocaine, bupivacaine and hyaluronidase for vitreoretinal surgery. However, a randomized controlled clinical trial is needed to prove the efficacy and safety of these results. |
| first_indexed | 2024-12-20T12:26:32Z |
| format | Article |
| id | doaj.art-09160a89e41a421dade26117458c6370 |
| institution | Directory Open Access Journal |
| issn | 0301-4738 |
| language | English |
| last_indexed | 2024-12-20T12:26:32Z |
| publishDate | 2002-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-09160a89e41a421dade26117458c63702022-12-21T19:40:51ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47382002-01-01503205208Peribulbar anaesthesia using a combination of lidocaine, bupivocaine and clonidine in vitreoretinal surgeryCalenda EmileQuintyn JeanBrasseur Gerard<b>Purpose: </b>The efficacy and safety of peribulbar anaesthesia was assessed using a combination of lidocaine, bupivacaine and clonidine during eye surgery. <b>Methods: </b>We prospectively studied 100 vitreo-retinal surgical procedures performed by several surgeons. The exclusion criteria included age below 30 years and, axial length of the orbit above 28 mm. Peribulbar was performed using Hamilton′s technique. A mixed anaesthetic solution of equal quantity of lidocaine 2% and bupivacaine 0.5% with clonidine (1mg/kg) was injected. Patients received a mean volume of 14.5 ml ± 3.5 of the mixture. Akinesia and analgesia were assessed 15 minutes later by the surgeon. Whenever required, supplemental lidocaine 2% (3 ml) by sub- Tenon infiltration was added by the surgeon. Supplemental injections were given only to patients who failed to develop analgesia. <b>Results: </b>The mean age of patients (male 52%, female 48%) was 66 years ± 10 (mean ± SD, range 44-90). The 100 surgical procedures were made up of vitrectomy ± gas ± silicone oil (22/100), vitrectomy and lensectomy (6/100), vitrectomy and epiretinal membrane ± laser coagulation ± gas ± silicone oil (35/100), scleral buckling or encircling ± gas (36/100), and cryosurgery ± gas (1/100). Analgesia was adequate throughout surgery without any supplementation in 85% of cases and with a sub-Tenon infiltration in 99%. Akinesia was complete in 84%, mild in 12% and absent in 4% of cases. The sub-Tenon injection was performed in 15% of cases. Three patients (3%) were agitated during surgery. No neurologic or cardiac complication was seen. In one patient, the systolic blood pressure decreased from 170 to 110 mmHg, 30 minutes after the institution of the peribulbar block. <b>Conclusion: </b>Our results show that peribulbar anaesthesia in the proposed mixture offers excellent analgesia in 85% of patients, and in 99% of the patients when supplemented by a subtenon injection. The current mixture of lidocaine, bupivacaine and clonidine is an excellent alternative to the previously used mixture etidocaine, bupivacaine and hyaluronidase for vitreoretinal surgery. However, a randomized controlled clinical trial is needed to prove the efficacy and safety of these results.http://www.ijo.in/article.asp?issn=0301-4738;year=2002;volume=50;issue=3;spage=205;epage=208;aulast=CalendaPeribulbar anaesthesiaclonidinelocal anaesthesiavitrectomyretinal detachment |
| spellingShingle | Calenda Emile Quintyn Jean Brasseur Gerard Peribulbar anaesthesia using a combination of lidocaine, bupivocaine and clonidine in vitreoretinal surgery Indian Journal of Ophthalmology Peribulbar anaesthesia clonidine local anaesthesia vitrectomy retinal detachment |
| title | Peribulbar anaesthesia using a combination of lidocaine, bupivocaine and clonidine in vitreoretinal surgery |
| title_full | Peribulbar anaesthesia using a combination of lidocaine, bupivocaine and clonidine in vitreoretinal surgery |
| title_fullStr | Peribulbar anaesthesia using a combination of lidocaine, bupivocaine and clonidine in vitreoretinal surgery |
| title_full_unstemmed | Peribulbar anaesthesia using a combination of lidocaine, bupivocaine and clonidine in vitreoretinal surgery |
| title_short | Peribulbar anaesthesia using a combination of lidocaine, bupivocaine and clonidine in vitreoretinal surgery |
| title_sort | peribulbar anaesthesia using a combination of lidocaine bupivocaine and clonidine in vitreoretinal surgery |
| topic | Peribulbar anaesthesia clonidine local anaesthesia vitrectomy retinal detachment |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2002;volume=50;issue=3;spage=205;epage=208;aulast=Calenda |
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