Tawfik, D., Mahmoud, S., Osama, N. (2020). Effect of Dexamethasone as A Local Anesthetic Adjuvant for Peribulbar Block in Vitreoretinal Eye Surgeries. The Egyptian Journal of Hospital Medicine, 79(1), 457-461. doi: 10.21608/ejhm.2020.81283
Dalia S. Tawfik; Sara R. Mahmoud; Noha A. Osama. "Effect of Dexamethasone as A Local Anesthetic Adjuvant for Peribulbar Block in Vitreoretinal Eye Surgeries". The Egyptian Journal of Hospital Medicine, 79, 1, 2020, 457-461. doi: 10.21608/ejhm.2020.81283
Tawfik, D., Mahmoud, S., Osama, N. (2020). 'Effect of Dexamethasone as A Local Anesthetic Adjuvant for Peribulbar Block in Vitreoretinal Eye Surgeries', The Egyptian Journal of Hospital Medicine, 79(1), pp. 457-461. doi: 10.21608/ejhm.2020.81283
Tawfik, D., Mahmoud, S., Osama, N. Effect of Dexamethasone as A Local Anesthetic Adjuvant for Peribulbar Block in Vitreoretinal Eye Surgeries. The Egyptian Journal of Hospital Medicine, 2020; 79(1): 457-461. doi: 10.21608/ejhm.2020.81283
Effect of Dexamethasone as A Local Anesthetic Adjuvant for Peribulbar Block in Vitreoretinal Eye Surgeries
Department of Anesthesia, Research Institute of Ophthalmology, Cairo, Egypt
Abstract
Background: Off label use of dexamethasone as an adjuvant to local anesthesia has been utilized to prolong single injection techniques. Objectives: To assess the beneficial effect of dexamethasone on peribulbar block in vitreoretinal surgeries. Patients and Methods: Patients undergoing vitreoretinal surgeries were randomized into 2 groups (10 patients each). They were given peribulbar block in the form of single medial canthus injection in a mixture of 8-10 ml of lidocaine 2% and bupivacaine 0.5% added to hyaluronidase 30 IU given by 25G, 1" needle. Group 1 received the block in addition to 4 ml dexamethasone. All patients got preoperative sedation in the form of 20 mic fentanyl, 1 mg midazolam and 20 mg propofol. Primary outcomes were onset of the block, pain during injection according to the visual analog scale (VAS) score, the need to supplement the block or sedation during surgery. Secondary outcomes were hemodynamics (heart rate, mean arterial blood pressure, oxygen saturation), patient satisfaction and surgeon satisfaction. Results: The mean onset of sensory and motor block in group 1 was significantly less (6.2+1.9) than group 2 (9.9+0.3 minutes). The pain score in group 1 was significantly lower (4+0.8) than group 2 (6+0.9), and the need for supplementation of the block or sedation during surgery differed significantly between the groups in favor for group 1 where the need for both was much less. Conclusions: Addition of dexamethasone to peribulbar block in vitreoretinal surgery speeds up the onset of the block and adds to its efficacy.
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