الفهرس | Only 14 pages are availabe for public view |
Abstract Regional anesthesia is commonly used for ophthalmic surgery. Various ophthalmic surgeries require a potent motor blockade (akinesia) of the eyeball and eyelids. Sub-Tenon’s anesthesia, sometimes also called parabulbar anesthesia, places the injection into the episcleral space. This allows the local anesthetic to spread circularly all around the scleral portion of the globe, thus accounting for high-quality analgesia of the whole globe with relatively low volumes injected (usually 6 mL). Clonidine’s addition to local anesthetic in retrobulbar block has several advantages: it decreases IOP, enhances anesthesia and akinesia and increases intraoperative sedation. The duration of lid and globe akinesia, globe analgesia and anesethesia was significantly increased with clonidine in peribulbar block. In our study we compared the effect of addition of clonidine to mepivacaine 3% in sub-tenon’s block as regard efficacy, safety and satisfaction of the patient. 60 patients were allocated randomly in two equal groups 30 patients each. Patients of Group A (Control group) received subTenon’s block using local anesthetic mixture of 5 ml Mepivacaine 3% solution with 1 ml normal saline 0.9% containing hyaluronidase 75 I.U. For patients belonging to Group B (Clonidine group) received sub-Tenon’s block using local anesthetic mixture of 5ml Mepivacaine 3% solution with 75µg clonidine (0.5 ml) plus 0.5 ml normal saline 0.9% containing hyaluronidase 75 I.U. Recorded data included motor blockade (akinesia) was used as the main index of anesthesia effectiveness. Patientreported pain during administration of anesthesia, during surgery, and after surgery (during the first six postoperative hours) was recorded, sedation level was monitored during the procedure and during the first two postoperative hours, patients’ global satisfaction level was assessed. Arterial blood pressure, heart rate, respiratory rate and oxygen saturation were evaluated after local anesthetic injection for two hours. At the end, complications were recorded. The results showed that 75µg clonidine has prolonged postoperative analgesia with good sedation level and hemodynamic stability when added to mepivacaine 3% in subtenon’s block for ophthalmic anterior segment surgery with no increase in incidence of complications. |