Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:3.2.1.36 (hyaluronidase)
4,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bupivacaine 0.75% with epinephrine and/or hyaluronidase and lidocaine 2% with epinephrine and hyaluronidase were compared as to onset and duration of surgical anesthesia and akinesia in a prospective, randomized, double-blind study in 111 patients undergoing 128 elective intraocular surgical procedures. There was no significant difference in onset time to adequate surgical anesthesia among any of the drug groups at 15 minutes following retrobulbar injection, but the bupivacaine with epinephrine group lagged for akinesia. Mean duration of akinesia was 11 hours for the bupivacaine groups compared to four hours for lidocaine. During the eight hours following surgery, 70-90% of the patients receiving bupivacaine required no postoperative analgesia compared to less than 40% of the lidocaine group. There were no drug-related complications.
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PMID:Bupivacaine and lidocaine retrobulbar anesthesia. A double-blind clinical study. 634 30

In ophthalmic surgeries requiring akinesia of the levator and orbicularis oculi muscles, a modified retrobulbar nerve block utilizing 0.75% bupivacaine hydrochloride with hyaluronidase in adequate dosage greatly reduces the need for a seventh nerve block, thus reducing patient discomfort.
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PMID:A technique of retrobulbar block with paralysis of orbicularis oculi. 663 17

Fifty-four consecutive cases of single injection peribulbar anaesthesia performed by the same ophthalmologist were evaluated concerning clinical effect on motility/akinesia and pain. The patients were randomly selected to one of two different mixtures of anaesthetics, one containing lidocaine, bupivacaine, adrenaline and hyaluronidase. The other lidocaine and bupivacaine. The mixture with adrenalin and hyaluronidase was significantly more effective than the other (success rates of 77.8% and 25.9%, p < 0.005).
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PMID:Peribulbar anaesthesia. A clinical evaluation of two different anaesthetic mixtures. 774 81

Alkalinized bupivacaine 0.75% (pH 6.8) and a mixture (1:1) of bupivacaine 0.75% and lidocaine 2%, both with hyaluronidase, were compared in regional ophthalmic anesthesia for day-case cataract surgery. Eighty-two patients were randomized into two groups (n = 39 and 43) to receive one of the two solutions in a double-blind manner. Two intraorbital injections were administered initially: an inferolateral intraconal injection (3 mL) and a medial extraconal injection (3.5 mL). The progress of lid and globe akinesia was examined every 2.5 min up to 25 min and postoperatively. The block was supplemented at 10 and 20 min, if needed. Significantly better globe akinesia was achieved with the bupivacaine-lidocaine mixture; the patients who had received alkalinized bupivacaine needed additional injections significantly more often at 10 and 20 min. In lid akinesia, the onset time and recovery were similar in the two groups. One patient in the alkalinized bupivacaine group felt intraoperative pain, and eight patients in the bupivacaine-lidocaine group and seven in the alkalinized bupivacaine group sensed pain postoperatively from corticosteroid and antibiotic injections. Seventy percent of the pH-adjusted bupivacaine group and 8% of the lidocaine-bupivacaine group had diplopia the day after surgery. Of the two local anesthetic mixtures studied, lidocaine (2%) with bupivacaine (0.75%) provided regional ophthalmic anesthesia of better quality.
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PMID:Comparison of pH-adjusted bupivacaine 0.75% and a mixture of bupivacaine 0.75% and lidocaine 2%, both with hyaluronidase, in day-case cataract surgery under regional anesthesia. 801 Apr 50

Prilocaine (Citanest) has been shown to be a satisfactory alternative to lignocaine, with certain important advantages, including superior diffusion. The latter may be especially important in peribulbar anesthesia, where the level of diffusion is a critical factor in providing a timely, high-quality block. In a prospective randomized study, we compared the effectiveness of peribulbar vs retrobulbar administration of prilocaine. Eighty-seven patients undergoing elective intraocular surgery were randomized to receive either retrobulbar or peribulbar anesthesia with prilocaine 3% with felypressin and hyaluronidase. Pain of injection, akinesia, and anesthesia were evaluated at predetermined intervals after injection. Except for the fact that lid akinesia occurred earlier in the peribulbar group, there was no difference in the quality or rate of onset of overall akinesia in the two groups. Nor were there any differences in the pain associated with injection. Both groups had excellent operative anesthesia and akinesia.
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PMID:Peribulbar and retrobulbar anesthesia with prilocaine: a comparison of two methods of local ocular anesthesia. 811 1

One-hundred and thirty-nine consecutive cases of retrobulbar blocks were evaluated concerning clinical effect on motility and pain. The patients were randomly selected to one of four different mixtures of anaesthetics. A mixture containing lidocaine w/adrenaline, bupivacaine w/adrenaline and hyaluronidase was shown to be significantly more effective than any of the other tested mixtures concerning analgesia and significantly better than mixtures without hyaluronidase concerning motility/akinesia.
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PMID:Retrobulbar anaesthesia. A clinical evaluation of four different anaesthetic mixtures. 815 54

The success rate and duration of lid akinesia after adding hyaluronidase and/or epinephrine to pH-adjusted bupivacaine was examined in a double-blind fashion in patients undergoing cataract surgery under local anaesthesia. A two-injection-site technique was used. For globe akinesia all patients (n = 120) received an inferolateral intraconal injection (3 ml) of pH-adjusted bupivacaine 0.75% and hyaluronidase. Lid akinesia was obtained with a medial extraconal injection (3.5 ml) of alkalinized bupivacaine with or without an adjunct. The patients were randomized to four groups as follows: a medial injection of plain bupivacaine (n = 31), with added hyaluronidase (n = 30), with added epinephrine (n = 29) or with both epinephrine and hyaluronidase (n = 30). The final solutions had a pH of 6.7. Lid akinesia was supplemented with periosteal injections if needed. The degree of akinesia from clinical assessment was graded from 0-2 and also measured with electromyography at ten minute intervals for 30 min after surgery, and three hours after the block. The least satisfactory result (P < 0.01) and shortest duration of the lid block (P < 0.05) was obtained with plain pH-adjusted bupivacaine. No differences in the success rate or duration of the block among the other groups were seen. The duration of the block was longer in the epinephrine groups than in the two other groups (P < 0.01) and longer in the epinephrine and hyaluronidase group than in the group receiving only hyaluronidase (P < 0.05). We conclude that the best initial results and longest duration of blocks were shown in the groups receiving epinephrine or epinephrine and hyaluronidase.
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PMID:Orbicular muscle akinesia in regional ophthalmic anaesthesia with pH-adjusted bupivacaine: effects of hyaluronidase and epinephrine. 826 62

Two concentrations of etidocaine (1 and 1.5%) and of pH-adjusted bupivacaine (0.5 and 0.75%, pH 6.8), all fortified with hyaluronidase, were compared as local anesthetics in regional ophthalmic surgery for cataract extraction. The series comprised 160 patients assigned randomly to four groups (n = 40). Each patient received one of the four anesthetics in a double blind manner. The technique used was an inferolateral intraconal injection (3 mL) followed by a medial extraconal injection (3 mL). Supplemental injections were given at 10 and 20 min, if needed. At 10 min, globe akinesia was satisfactory in both etidocaine groups and in the 0.75% bupivacaine group (78-80% of patients), but in only 37% of the 0.5% bupivacaine group. In lid akinesia, the 0.75% bupivacaine group gained the highest scores, but there was no significant difference between the groups. Perioperative analgesia was better in both bupivacaine groups, in which only 3 and 5 patients felt pain compared to 7 and 12 in the etidocaine groups (P < 0.05). Of these local anesthetics, pH-adjusted 0.75% bupivacaine is recommended for regional ophthalmic anesthesia.
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PMID:Comparison of regional ophthalmic anesthesia produced by pH-adjusted 0.75% and 0.5% bupivacaine and 1% and 1.5% etidocaine, all with hyaluronidase. 831 20

Orbital regional anesthesia is the only circumstance where hyaluronidase is routinely added to local anesthetics to accelerate the onset of the block. The aim of this study was to compare the pharmacokinetics of lidocaine and bupivacaine with or without hyaluronidase for peribulbar blockade. Twenty-one patients scheduled for cataract surgery with lens implantation were included in this prospective randomized study. Peribulbar blocks were achieved with plain bupivacaine 0.5% (5.5 mL), lidocaine 2% (5.5 mL), and hyaluronidase (100 IU = 2 mL) (n = 10) ir sterile water (2 mL) (n = 11). Plasma bupivacaine and lidocaine concentrations were measured by high-performance liquid chromatography at regular intervals from the end of the local anesthetic injection until the 360th minute. Maximum plasma concentration (Cmax) and time to reach Cmax (Tmax) were obtained for all the patients except one who needed a supplementary injection and was excluded from the study. The time to onset and duration of the analgesia and akinesia were monitored at the times of sampling. Motor blockade was incomplete in two patients in each group without affecting surgery. The Tmax and absorption half-life (t1/2a) of lidocaine and bupivacaine were not different within each group (P > 0.05). The Tmax of lidocaine was shorter in the presence of hyaluronidase (17.1 +/- 2.6 min vs 32.7 +/- 6.0 min) as well as the Tmax of bupivacaine (16.8 +/- 3.0 min vs 26.5 +/- 4.4 min). The Cmax of lidocaine and bupivacaine were not modified by the addition of hyaluronidase. The clearance, terminal half-life, and volume of distribution were not different between groups. The absorption of lidocaine and bupivacaine from the peribulbar space are hastened by the addition of hyaluronidase. The Tmax of lidocaine is not different from that of bupivacaine within each group suggesting that the absorption of local anesthetics is minimally influenced by the liposolubility of the drugs. Moreover, hyaluronidase influences the absorption kinetics of both lidocaine and bupivacaine in the same manner.
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PMID:The role of hyaluronidase on lidocaine and bupivacaine pharmacokinetics after peribulbar blockade. 861 Aug 68

We studied the effect of the addition of hyaluronidase to a mixture of lignocaine 2% and bupivacaine 0.75% for peribulbar anaesthesia in 60 patients presenting for elective intra-ocular surgery. Using a randomised, double-blind design, patients were allocated to one of three groups: no hyaluronidase (group A) (n = 20); hyaluronidase 50 iu.ml-1 (group B) (n = 20); hyaluronidase 150 iu.ml-1 (group C) (n = 20). The speed of onset of the block, the presence of akinesia, analgesia and the need for supplementary injections were assessed. The addition of 150 iu.ml-1 of hyaluronidase resulted in a mean (SEM) time to akinesia of 9.2 (0.9) min compared to 10.9 (0.9) min in the control group and 10.7 (1.1) min in those receiving the lower dose. Fewer patients in group C required a further injection (20%) than those in groups A (40%) or B (45%). None of the findings were statistically significant. Hyaluronidase was not associated with any complications.
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PMID:An evaluation of two concentrations of hyaluronidase for supplementation of peribulbar anaesthesia. 869 95


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