الفهرس | Only 14 pages are availabe for public view |
Abstract this prospective, randomized, double blind study was conducted in EL-Minia University hospital during the period from January 2016 to January 2017. The study involved one hundred and twenty adult patients aged between 18 to 70 years of either who were undergoing cataract surgery under peribulbar block. The patients were randomly allocated into four groups of thirty patients each to receive peribulbar anesthesia:- 1)Articaine (A) group: articaine 4% with 1/200000 epinephrine + 150 IU hyaluronidase. 2)Lidocaine (L) group : lidocaine 2% with 1/200000 epinephrine +150 IU hyaluronidase. 3)Articaine - dexmedetomidine (AD) Group: articaine 4% with 1/200000 epinephrine + 150 IU hyaluronidase + 50 μg of dexmedetomidine. 4)Lidocaine - dexmedetomidine (LD) group : lidocaine 2% with 1/200000 epinephrine + 150 IU hyaluronidase + 50 μg of dexmedetomidine. All patients were assessed in terms of:- 1.Total LA volume and need of LA supplementation. 2.Hemodynamics (mean arterial blood pressure, heart rate) and SaO2 preoperatively and at 10 and 20min. after injection. 3.Onset and duration of globe and eye lid akinesia (ocular and eyelids movement score). Articaine was superior to lidocaine in achieving significantly shorter onset and prolonged duration of globe akinesia and corneal anesthesia, lower LA volume and less need of LA supplementation consequently lower intraoperative IOP. But there was no significant difference in onset or duration of eyelid akinesia. The addition of 50ug of dexmedetomidine to articaine and lidocaine produced shorter onset and longer duration of globe akinesia, better pain score with lower analgesic requirement, more sedation and more patient satisfaction for each of them than that of either of them alone. Also addition of dexmedetomidine to lidocaine was having other advantages of better hemodynamics, decrease LA supplementation and IOP in comparison to lidocaine alone to the extent that the mixture of LD became comparable to articaine. |