Cataract Surgeries, Dexamethasone, Dexmedetomidine, Local Anesthetic, Peribulbar Block
Conditions
Brief summary
This study aimed to compare the effects of dexamethasone and dexmedetomidine when added to a local anesthetic mixture for peribulbar block in patients undergoing elective anterior segment eye surgery.
Detailed description
Regional block (especially peribulbar block) is the preferred choice of anesthesia for many ophthalmic surgeries as it has less complications. Peribulbar block with local anesthetics only lead to delayed onset corneal anesthesia and globe akinesia, and frequent need of block supplementation. Dexmedetomidine is a drug which belongs to alpha 2 adrenergic receptor agonist. It provides several desirable effects, including sedation, anxiolysis, analgesia, and a reduction in intraoperative opioid requirements, when used as an adjuvant to local anesthetics, dexmedetomidine has been shown to prolong the duration of sensory and motor blocks, improve hemodynamic stability, and enhance overall patient satisfaction. Dexamethasone, a synthetic corticosteroid, the use of dexamethasone as an additive in peribulbar blocks has been shown to improve the quality of anesthesia, reduce the need for supplemental intraoperative analgesics, and decrease postoperative pain.
Interventions
DRUGDexmedetomidine
Patients received 20 μg of dexmedetomidine in 1 ml solution.
DRUGDexamethasone
Patients received 4 mg dexamethasone in 1 ml solution.
DRUGNormal saline
Patients received 1 ml normal saline.
Sponsors
Helwan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age: \> 18 years old. * Sex: Male \& Female * American Society of Anesthesiologists (ASA) Physical status I -III. * Patients undergoing ophthalmic surgery under local anesthesia.
Exclusion criteria
* Patients' refusal. * Patients have active ocular infection. * Patients have single eyes. * Allergy to thesis medications (mainly bupivacaine and lidocaine). * Patients cannot lie flat. * Patient on anticoagulation. * Abnormal coagulation profile in the form of international normalized ratio (INR) ≥1.6
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time for first request of the rescue analgesia | 24 hours postoperatively | Time for first request of the rescue analgesia was recorded from the end of surgery till first dose of morphine administrated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative opioid consumption | 12 hours postoperatively | If the Visual analogue score (VAS) was \>4, a 0.1 mg/kg bolus dose of intravenous morphine will be administered if no response the bolus dose will be repeated with a maximum dose of 10 mg. |
| Degree of patient satisfaction | 24 hours postoperatively | Degree of patient satisfaction was assessed on a 4-point scale (1, excellent; 2, good; 3, fair; 4, poor). |
| Degree of pain | 12 hours postoperatively | Each patient was instructed about postoperative pain assessment with VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS was recorded , 2, 4, 8, and 12 hours postoperatively. |
| Heart rate | 12 hours postoperatively | Heart rate was measured before and after the peribulbar injection (baseline) (5,10, 15, 30, 45, 60, 90 till 120 min) the each 6 hours for 12 hours postoperatively. |
| Mean arterial blood pressure | 12 hours postoperatively | Mean arterial blood pressure was measured before and after the peribulbar injection (baseline) (5,10, 15, 30, 45, 60, 90 till 120 min) the each 6 hours for 12 hours postoperatively. |
| Intraocular pressure | 10 min after injection of local anesthetics | Intraocular pressure (IOP) was measured 30 min before injection of the local anesthetics as a baseline reading. The other reading 10 min after injection of local anesthetics. |
Countries
Egypt
Outcome results
None listed