The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery
Abu Elyazed, M., Abdelghafar, M., Mogahed, M., Nassif, M. (2017). The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery. EKB Journal Management System, 33(3), 245-250. doi: 10.1016/j.egja.2017.05.005
Mohamed M. Abu Elyazed; Mohamed Samir Abdelghafar; Mona Mohamed Mogahed; Mohamed Abdelhameed Nassif. "The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery". EKB Journal Management System, 33, 3, 2017, 245-250. doi: 10.1016/j.egja.2017.05.005
Abu Elyazed, M., Abdelghafar, M., Mogahed, M., Nassif, M. (2017). 'The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery', EKB Journal Management System, 33(3), pp. 245-250. doi: 10.1016/j.egja.2017.05.005
Abu Elyazed, M., Abdelghafar, M., Mogahed, M., Nassif, M. The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery. EKB Journal Management System, 2017; 33(3): 245-250. doi: 10.1016/j.egja.2017.05.005

The effect of adding cisatracurium versus hyaluronidase to levobupivacaine and lidocaine mixture in single injection peribulbar block for cataract surgery

Egyptian Journal of Anaesthesia
Volume 33, Issue 3, July 2017, Page 245-250  XML PDF (1 MB)
DOI: 10.1016/j.egja.2017.05.005
View on SCiNiTO View on SCiNiTO
Authors
Mohamed M. Abu Elyazed; Mohamed Samir Abdelghafar; Mona Mohamed Mogahed; Mohamed Abdelhameed Nassif
Abstract
Background
Several adjuvants can be utilized to improve the quality of peribulbar block (PBB). We compared the effects of adding cisatracurium or hyaluronidase to levobupivacaine and lidocaine mixture for PBB on the onset of globe and lid akinesia in cataract surgery.
Methods
105 adult patients scheduled for cataract surgery under PBB were randomly allocated into three groups. Control group received 4 ml 0.5% levobupivacaine plus 3 ml 2% lidocaine diluted in saline to a total volume of 8 ml. Hyaluronidase 15 IU/ml and cisatracurium 1 mg were added to local anesthetics (LAs) mixture in hyaluronidase and cisatracurium groups respectively. Onset and duration of lid and globe akinesia, time for adequate conditions to start surgery and adverse events were recorded. Distribution of LAs solution was evaluated by B-scan ultrasound at 3 min and 10 min after injection of LAs.
Results
Onset of lid and globe akinesia, as well as time to adequate conditions to start surgery, were faster in cisatracurium and hyaluronidase groups compared to the control group (P < 0.05). Cisatracurium group had the fastest onset. At 3 min after injection of LAs, the ultrasound examination revealed that hyaluronidase group had the highest percentage of patients showing intraconal diffusion of LAs solution with the appearance of a characteristic T sign (P < 0.05).
Conclusions
The addition of cisatracurium 1 mg or hyaluronidase 15 IU/ml to levobupivacaine and lidocaine mixture for PBB hastened the onset of lid and globe akinesia without increase the incidence of adverse effects. This effect is more obvious with cisatracurium compared to hyaluronidase.
Statistics
Article View: 21
PDF Download: 12