Posters

Effectiveness of using dexmedetomidine as an adjunct to local anaesthesia in peribulbar block in ocular surgeries

Poster Details

First Author: A.Morya INDIA

Co Author(s):    S. Gogia   N. Parashar   R. Gupta   S. Sahu   K. Solanki        

Abstract Details

Purpose:

To evaluate the effect of dexmedetomidine, a centrally acting α2-adrenergic receptor agonist as an adjunct to local anaesthetics in peribulbar block in ocular surgeries.

Setting:

Department of Ophthalmology, All India Institute of Medical Sciences, Jodhpur, India

Methods:

120 patients of either gender undergoing various ocular surgeries under peribulbar blockade were divided into two groups of 60 each - Group A receiving - 3ml lignocaine+ 2ml bupivacaine+ 150 IU hyaluronidase; Group B receiving -3ml lignocaine+ 2ml bupivacaine+ 150 IU hyaluronidase + 25mcg dexmedetomidine. We evaluated the effect of dexmedetomidine on onset of globe akinesia, duration of block, intraocular pressure, heart rate, mean arterial pressure. Sedation levels were assessed using Ramsay Sedation scale every 10 minutes during surgery. Pain score was assessed using visual analogue scale and surgeon satisfaction was assessed using 5 point likert like verbal rating scale.

Results:

Time of onset of action was shortened and duration of block was increased significantly in group B as compared to group A (p<0.05).The intraocular pressure decreased throughout the first 10 min after the administration of the local anaesthesia in Group B (p<0.05). As regards the conscious level in the two groups, there was a significant difference (P < 0.0001). Group A is higher regarding score 1 and 2, and Group B higher in score 3. Pain score was significantly decreased in the dexmedetomidine group. However, group B showed more changes in heart rate and blood pressure.

Conclusions:

Addition of dexmedetomidine to lignocaine and bupivacaine in a peribulbar block significantly shortened onset time, decreased the IOP, and prolonged the duration of anaesthesia that lead to increased patient cooperation and surgeon satisfaction. Also, the blood pressure reducing effects makes it more beneficial in hypertensive patients and a contraindication to use in cases of hypotension especially glaucomatous individuals. There is no financial disclosure of the Principal Investigator.

Financial Disclosure:

None