Dacryocystorhinostomy, Dexmedetomidine, General Anesthesia, Hemodynamic Effect, Lidocaine, Magnesium Sulphate, Peribulbar Block
Conditions
Brief summary
This study aims to compare the hemodynamic effect of dexmedetomidine and magnesium sulphate as an adjuvant to lidocaine in preemptive peribulbar block in patients undergoing Dacryocystorhinostomy (DCR) under general anaesthesia (GA) .
Detailed description
Dacryocystorhinostomy (DCR) is a delicate ophthalmic surgical procedure aimed at reestablishing the patency of the nasolacrimal duct in patients suffering from nasolacrimal duct obstruction (NLDO). Magnesium is a non-competitive N-methyl-D-aspartate (NMDA) receptors antagonist, and it can decrease the excitatory post synaptic currents produced by activation of NMDA receptors and it inhibits voltage gated calcium channels. Dexmedetomidine alpha-2 agonist, which stimulates both central and peripheral alpha-2 receptors which inhibits neuronal firing and inhibits release of C-fibers transmitters such as norepinephrine which inhibits nerve fiber action potential and explains the antinociceptive effects of dexmedetomidine.
Interventions
Patients will receive 5 ml of lidocaine 2% + 50 µg dexmedetomidine, with a total volume of 7 ml.
DRUGLidocaine + Magnesium sulphate
Patients will receive 5 ml of lidocaine 2% + 100 mg magnesium sulphate 10%, with a total volume of 7 ml.
DRUGLidocaine
Patients will receive 7 ml of lidocaine 2% with no further additives.
Sponsors
Cairo 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. * Both sexes. * American Society of Anesthesiologists (ASA) physical status I or II. * Undergoing elective Dacryocystorhinostomy (DCR) surgery under general anesthesia.
Exclusion criteria
* Patients have local infection. * Allergic reaction or complications of the local anaesthesia (LA). * Coagulopathy defined as international normalized ratio (INR) \> 1.5, platelet count \< 100,000/mm³, or ongoing anticoagulant therapy not adequately discontinued. * Uncontrolled systemic disease, defined as poorly controlled hypertension \[systolic blood pressure (SBP) \> 160 mmHg\], uncontrolled diabetes mellitus (HbA1c \> 8.5%), unstable ischemic heart disease, or decompensated hepatic or renal disease. * Uncooperative patients.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in mean arterial blood pressure | Till the end of surgery (Up to 2 hours) | The change in mean arterial blood pressure will be recorded at baseline, after induction of anesthesia, immediately before peribulbar block, after block administration, at skin incision, during osteotomy and lacrimal sac manipulation (oculocardiac reflexes-provoking steps), and every 5 minutes thereafter until the end of surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | Till the end of surgery (Up to 2 hours) | Heart rate will be recorded at baseline, after induction of anesthesia, immediately before peribulbar block, after block administration, at skin incision, during osteotomy and lacrimal sac manipulation (oculocardiac reflexes-provoking steps), and every 5 minutes thereafter until the end of surgery. |
| Oxygen saturation | Till the end of surgery (Up to 2 hours) | Oxygen saturation will be recorded at baseline, after induction of anesthesia, immediately before peribulbar block, after block administration, at skin incision, during osteotomy and lacrimal sac manipulation (oculocardiac reflexes-provoking steps), and every 5 minutes thereafter until the end of surgery. |
| Degree of patient satisfaction | 24 hours postoperatively | Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied) |
| Degree of surgeon satisfaction | 24 hours postoperatively | Degree of surgeon satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied) |
Countries
Egypt
Contacts
CONTACTHebatullah S Abdelhamid, MD
Outcome results
None listed