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)

The aim of this prospective double-blind study was to evaluate the effect of the pressure on injection of local anaesthetic during peribulbar anaesthesia. Fifty patients scheduled for cataract surgery under peribulbar anaesthesia, with a two injection site technique, were randomly assigned to receive a mixture of 5 ml of etidocaine 1%, 4 ml of bupivacaine 0.5% and hyaluronidase 50 IU, injected under a constant pressure of either 140 g.cm-2 (group 1) or 250 g.cm-2 (group 2). After orbital compression, the degree of akinesia of the extra-ocular and orbicular muscles was graded by clinical assessment. A significantly higher rate of satisfactory akinesia of the extra-ocular muscles was found in group 2 (72% vs 28% in group 1) (p < 0.01). No significant relationship was found between the time taken to administer the anaesthetic mixture at constant pressure and the quality of the block.
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PMID:Effect of injection pressure on the success rate of peribulbar block. 879 25

A prospective, randomised controlled study was performed to investigate whether hyaluronidase improved the efficacy of peribulbar anaesthesia. Ninety-two patients undergoing peribulbar anaesthesia for intraocular surgery all received 10 ml of an anaesthetic solution consisting of a 50:50 mixture of 2% lignocaine with 1 in 200,000 adrenaline and 0.5% bupivacaine. Patients were randomised to a hyaluronidase group which received 150 IU/ml hyaluronidase in this anaesthetic solution (a higher concentration than previous studies) or a control group which received no hyaluronidase. There were 44 patients in the hyaluronidase group and 48 patients in the control group. All anaesthetic injections were administered by an experienced ophthalmologist and no supplementary injections were required in any case. The mean time interval between administration of the block and commencement of surgery was 22 minutes. No statistically significant difference was found between the two groups for pre-operative akinesia (p = 0.16), intraoperative akinesia (p = 0.25), eyelid paralysis (p = 0.72), objective analgesia (p = 0.23) or subjective analgesia (p = 0.60). The majority of patients in both groups achieved excellent akinesia, eyelid paralysis and analgesia. The reasons for these findings in the light of previously conflicting reports on the value of hyaluronidase in peribulbar anaesthesia are discussed.
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PMID:Is hyaluronidase helpful for peribulbar anaesthesia? 937 82

We have evaluated the effects of the volume and speed of administration of local anaesthetic during peribulbar anaesthesia. One hundred and forty patients scheduled for cataract surgery were randomly allocated to one of four groups of 35. Each patient received an injection of the same mixture of lignocaine, bupivacaine and hyaluronidase. Patients in group A were given 9 ml at a speed of 5 ml.min-1, group B were given the same volume at 12 ml.min-1, group C were given 13.5 ml at 5 ml.min-1 and group D were given 13.5 ml at 12 ml.min-1. A significantly higher incidence of satisfactory akinesia was found in group D, whose pain score at injection was no higher than for the other groups. Large volumes of local anaesthetic significantly affected intra-ocular pressure. The incidences of early and late ptosis or diplopia were not affected by either the rate of injection or the volume of local anaesthetic.
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PMID:The effects of volume and speed of injection in peribulbar anaesthesia. 965 24

The aim of this double-blind, randomised study was to assess the effects of the addition of 0.5 mg of vecuronium bromide to a standard local anaesthetic mixture used for peribulbar anaesthesia. We studied 60 patients undergoing regional anaesthesia for intra-ocular surgery and were primarily interested in the quality of globe and lid akinesia. All received a mixture of 5 ml 2% lignocaine with 1:200,000 adrenaline, 5 ml 0.75% bupivacaine and 150 IU hyaluronidase with either 0.9% saline 0.25 ml (group A, n = 30) or vecuronium bromide 0.25 ml (0.5 mg) (group B, n = 30). Eye movements assessed at both 5 and 10 min were significantly reduced in the vecuronium group (group B) (p < 0.05). We conclude that the addition of vecuronium at a dose of 0.5 mg to the standard local anaesthetic mixture improves the quality of globe and lid akinesia.
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PMID:Peribulbar anaesthesia using a mixture of local anaesthetic and vecuronium. 1157 32

The role of hyaluronidase on the onset time and quality of single quadrant sub-Tenon's block was studied in a prospective, randomized, double-blind controlled manner. One hundred and twenty consecutive patients undergoing cataract surgery under local anaesthesia received a sub-Tenon's block with either of two local anaesthetic solutions. One consisted of 2% plain lignocaine 3 ml with 0.5% plain bupivacaine 2 ml. The other consisted of 2% lignocaine 1 ml containing 150 i.u. per ml of hyaluronidase with 2% plain lignocaine 2 ml and 0.5% plain bupivacaine 2 ml. The development of akinesia and the resulting block quality were assessed. Akinesia scores were lower at all time intervals and were significantly lower (P < 0.05) up to 9 minutes after block in the hyaluronidase group. However, block quality as assessed by the surgeon was not significantly different between the groups. The addition of 150 IU hyaluronidase significantly speeds up the onset of surgical anaesthesia produced by a sub-Tenon's block.
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PMID:Sub-Tenon's block: the effect of hyaluronidase on speed of onset and block quality. 1021 16

Peribulbar anaesthesia with 1% ropivacaine and 0.75% bupivacaine, both with hyaluronidase, was assessed in a prospective, randomised, double-blind study of 100 patients undergoing cataract surgery. Pharmacokinetic data were obtained from 22 subjects. Akinesia of the globe developed slightly more rapidly in the ropivacaine group, but this difference was only statistically significant at 2 min after injection of the local anaesthetic. Lid akinesia was significantly more complete in the ropivacaine group. There were no differences between the groups with respect to peri-operative analgesia or duration of akinesia. The dose-adjusted maximum concentration of ropivacaine was approximately twice that of bupivacaine with significantly higher values of the area under the concentration-time curves. No drug-related adverse effects were observed. We conclude that there are no clinically significant differences in the quality of the sensory and motor block between 1% ropivacaine and 0.75% bupivacaine when used for peribulbar anaesthesia.
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PMID:Clinical efficacy and pharmacokinetics of 1% ropivacaine and 0.75% bupivacaine in peribulbar anaesthesia for cataract surgery. 1021 8

The purpose of the study was to compare 1% ropivacaine and hyaluronidase 75 units/ml with a 1:1 mixture of 2% lignocaine and 0.5% bupivacaine and hyaluronidase 75 units/ml for peribulbar anaesthesia in cataract surgery. We conducted a double-blind randomized trial involving 100 patients. Group 1 received a peribulbar injection of 8 ml of 1% ropivacaine and hyaluronidase 75 units/ml. Group 2 received a peribulbar injection of 8 ml of a 1:1 mixture of 2% lignocaine and 0.5% bupivacaine and hyaluronidase 75 units/ml. Parameters measured were ocular and eyelid movement scores, time suitable for surgery, need for supplementary injections, verbal pain score and complications. No statistical differences were found between the two groups regarding any of the study parameters. Both groups had excellent surgical analgesia and akinesia. We conclude that 1% ropivacaine is a suitable agent for single injection peribulbar anaesthesia for cataract surgery.
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PMID:Comparison of 1% ropivacaine and a mixture of 2% lignocaine and 0.5% bupivacaine for peribulbar anaesthesia in cataract surgery. 1038 55

The low toxicity of ropivacaine makes it attractive for peribulbar anaesthesia. However, its motor-sparing properties are undesirable when akinesia is important. Hyaluronidase (300 IU ml-1) promotes the onset and quality of peribulbar blockade when used with other agents. We investigated the onset and quality of ocular akinesia in 80 patients randomized to receive 1% ropivacaine plus hyaluronidase 300 IU ml-1 (group 1), or bupivacaine 0.5%/Lidocaine 2% plus 50 IU ml-1 hyaluronidase (group 2). Ocular akinesia was scored from 0 (no movement) to 8 (full movement) every 2 min for 20 min. The groups showed no difference in the rate of onset or degree of akinesia achieved (analysis of variance with repeated measures; P = 0.34). Sixty per cent of patients in group 1 and 55% in group 2 achieved akinesia scores of < or = 4 by 6 min (chi 2 test; P = 0.5). We conclude that both peribulbar solutions produce equivalent onset and quality of ocular akinesia.
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PMID:Peribulbar anaesthesia with 1% ropivacaine and hyaluronidase 300 IU ml-1: comparison with 0.5% bupivacaine/2% lidocaine and hyaluronidase 50 IU ml-1. 1106 23

A prospective, randomized blind study was conducted in 40 patients undergoing phacoemulsification and posterior chamber intraocular lens implantation. They received anaesthetic infiltration of 2% lidocaine with 1:200,000 epinephrine and hyaluronidase 150 U ml(-1) in a volume of 2, 3, 4 or 5 ml into the sub-Tenon's fascial space through a Greenbaum cannula after a conjunctival incision. Reduction of ocular movements, anaesthesia, pain on injection and any incidental complications were recorded. Akinesia and anaesthesia occurred within 5 min with 4 and 5 ml of local anaesthetic, and no supplementary injections were required. There were marked reductions in the frequency of forced eyelid movements with these volumes. Chemosis and conjunctival haemorrhage were noted in the majority of patients but caused no intraoperative problems. Approximately 10-15% of patients reported slight discomfort at the time of injection. Four to 5 ml of 2% lidocaine with 1:200,000 epinephrine and 150 U ml(-1) of hyaluronidase is the optimum volume to achieve adequate akinesia, anaesthesia and reduction of lid movements during the Greenbaum sub-Tenon's block.
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PMID:Evaluation of the Greenbaum sub-Tenon's block. 1199 Feb 92

Clonidine added to local anaesthetics prolongs the duration of anaesthesia and analgesia of peripheral, neuraxial and retrobulbar blocks. The present randomized blinded controlled study was conducted to evaluate the effect of the addition of clonidine to local anaesthetic mixture on the quality, onset time, duration of peribulbar block, perioperative analgesia and patients' comfort. The study comprised two groups of 12 patients each. Group A (control) patients received 7 ml of a mixture of 2% lignocaine and hyaluronidase with 1 ml normal saline, while group B (clonidine group) patients had clonidine 1 microg/kg added to the above mixture. Onset and duration of lid akinesia, globe anaesthesia and akinesia, time to first analgesic medication and total analgesic requirement were assessed. Patients were monitored for heart rate, blood pressure, sedation and respiratory depression. Addition of clonidine to local anaesthetic mixture resulted in a significant increase in duration of lid akinesia (85.4+/-25.6 vs 173.3+/-35.3 min, P<0.001), globe anaesthesia (63.2+/-6.9 vs 78.8+/-17.5 min, P=0.012) and globe akinesia (161.3+/-24.3 vs 201.2+/-45.7 min, P=0.016). The onset time and quality of block were similar in both the groups. No significant haemodynamic, respiratory or sedative effects were recorded. The perioperative pain scores and the analgesic requirements were significantly (P<0.01) lower in group B patients. We found that addition of clonidine 1 microg/kg to local anaesthetic mixture significantly increases the duration of anaesthesia and analgesia after peribulbar block.
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PMID:Effect of addition of clonidine to local anaesthetic mixture for peribulbar block. 1218 May 81


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