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)

We have studied in 22 patients the effect of adding hyaluronidase to bupivacaine during axillary brachial plexus block (BPB) in a double-blind design. Patients received BPB using bupivacaine 2 mg kg-1 with adrenaline 1 in 200,000, either with or without hyaluronidase 3000 iu, in a volume of 0.5 ml per 2.54 cm of the patient's height. The use of hyaluronidase did not increase the speed of onset of anaesthesia or reduce the incidence of inadequate nerve block. Hyaluronidase produced a significant reduction in the duration of anaesthesia. Changes in grip strength and skin temperature were useful in assessing the onset and progress of BPB.
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PMID:Effect of addition of hyaluronidase to bupivacaine during axillary brachial plexus block. 173 71

Twenty patients had retrobulbar anesthesia with 5 ml mepivacaine (Scandicain) without or with addition of 150 units of hyaluronidase (Kinetin). Before and 15 min after injection, we determined--by means of oculo-oscillo-dynamography--the systolic retinal and ciliary perfusion pressures, the respective ocular blood pressures (intramural pressures) and the ocular pulsation volume (PVoc) as well as the intraocular pressure (Pio; hand-applanation tonometer). Without hyaluronidase, the ocular perfusion and blood pressures were lowered by 11.8 and 3.9 mmHg, respectively, and PVoc was reduced by 0,40 microliters, whereas Pio was increased by 7.9 mmHg With hyaluronidase, the ocular perfusion and blood pressures were decreased by averages of 12.7 and 6.8 mmHg, respectively, PVoc was reduced by 0.42 microliters, and Pio was increased by 6.0 mmHg. Within each group, all changes were significant. There were, however, no significant differences between the two groups, i.e., the "spreading factor" hyaluronidase does not influence the inhibitory effects of retrobulbar anesthesia on ocular circulation.
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PMID:[Effect of hyaluronidase on ocular circulatory changes caused by retrobulbar anesthesia]. 185 46

Scalp reduction has become an important part of the cosmetic surgeon's armamentarium in the treatment of male pattern alopecia. Recently, the use of two-stage tissue expansion has been advocated for scalp reduction. Intraoperative tissue expansion obviates many of the disadvantages of delayed expansion and increases the yield of excised scalp by 20-30% over standard reduction techniques in the 20 patients studied. The addition of hyaluronidase to the local anesthetic facilitates its diffusion, enhancing anesthesia and the ease of dissection. Therefore, the use of intraoperative tissue expansion and the addition of hyaluronidase to the local anesthetic are two separate adjuncts to scalp reduction surgery.
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PMID:Adjuncts to scalp reduction surgery. Intraoperative tissue expanders and hyaluronidase. 188 31

To determine the effectiveness of various combinations of lidocaine, epinephrine, and hyaluronidase with bupivacaine, a prospective, randomized, masked study on 117 patients having cataract extraction under local anesthesia was undertaken. All patients were given a 9 ml peribulbar block by one surgeon, and a graded assessment of analgesia and akinesia was made in a masked fashion one hour later. A mixture using all these agents gave significantly better results than any of the combinations (P = .001). No single agent was shown to be the major determinant of effectiveness. The result suggests a synergistic effect found only when all the agents are combined.
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PMID:Choice of anesthetic agents for peribulbar anesthesia. 200 63

The pH-adjustment of local anesthetic solutions with sodium bicarbonate may shorten onset time and improve spread of neural blockade. The authors undertook a prospective, double-masked, randomized study to see if a pH-adjusted mixture of lidocaine, bupivacaine, and hyaluronidase had faster and more complete onset of neural blockade, when used for peribulbar anesthesia. Eighty patients were randomly assigned to four groups and received a peribulbar block with one of four mixtures: group 1 (L) = 2% lidocaine, group 2 (LPH) = 2% lidocaine with 0.06 meq/ml sodium bicarbonate, group 3 (LE) = 2% lidocaine with 1:100,000 epinephrine (commercially prepared), or group 4 (LEPH) = 2% lidocaine with 1:100,000 epinephrine with 0.06 meq/ml sodium bicarbonate. To 5 ml of each of the preceding groups, 5 ml of 0.75% bupivacaine and 150 units of hyaluronidase was added. After each block, extraocular muscle movement was followed in each quadrant until akinesia developed. In the event of incomplete akinesia, blocks were supplemented at 20 minutes. The LPH group had the fastest onset to complete akinesia (7.0 +/- 2.0 minutes, mean +/- SEM) when compared with the onset time of all other groups (group 1 = 11.5 +/- 1.9 minutes, group 4 = 13.1 +/- 1.4 minutes, and group 3 = 16.0 +/- 1.8 minutes, significance greater than 95% by analysis of variance). Furthermore, when compared with group 3 by analysis of variance, group 4 had a faster onset time. The authors conclude that pH-adjustment of solutions with bicarbonate of either lidocaine/bupivacaine/hyaluronidase or commercially prepared lidocaine with epinephrine/bupivacaine/hyaluronidase decreases the onset time of peribulbar anesthesia.
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PMID:Peribulbar anesthesia. Effect of bicarbonate on mixtures of lidocaine, bupivacaine, and hyaluronidase with or without epinephrine. 200 83

We present a method of anesthesia for intraocular surgery of the anterior segment of the eye that avoids the risks of the potential complications associated with retrobulbar and peribulbar anesthesia. The method consists of topical anesthesia plus 0.5 cc of lidocaine (with hyaluronidase and epinephrine) injected beneath the superior conjunctiva. We have demonstrated the safety and effectiveness of this technique in 431 consecutive cases.
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PMID:Subconjunctival anesthesia: an alternative to retrobulbar and peribulbar techniques. 205 81

A double-masked, randomized clinical trial was conducted to determine if subcutaneous eyelid injections of a bicarbonate-buffered lidocaine-epinephrine-hyaluronidase mixture were less painful than unbuffered injections. Twenty-one patients received both buffered (pH = 7.4) and unbuffered (pH = 4.6) injections. After each injection, patients recorded pain on a scale of 0, "no pain," to 10, "severe pain." Mean pain score for buffered injections was 2.0 versus 4.1 for unbuffered injections (P = 0.0003). Seventeen (81%) of 21 patients ranked the buffered injection less painful. Use of a bicarbonate-buffered lidocaine-epinephrine-hyaluronidase mixture is effective in making ophthalmic anesthesia less painful.
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PMID:Bicarbonate-buffered lidocaine-epinephrine-hyaluronidase for eyelid anesthesia. 225 21

Day-case cataract surgery and the need for local anaesthesia are likely to increase. Retrobulbar (and peribulbar) anaesthetic injection is a common technique in cataract surgery, but serious complications are persistently reported. Subconjunctival injection is an alternative that avoids these risks. This retrospective study compares two groups of patients that underwent extracapsular cataract surgery under local anaesthetic. One group (retrobulbar) had uncomplicated retrobulbar injection with bupivicaine and hyaluronidase. The other group (non-retrobulbar) had superior bulbar, subconjunctival infiltration with bupivicaine and hyaluronidase. The operative complications and postoperative visual outcomes were similar in both groups. These results may encourage the investigation and adoption of the subconjunctival alternative to retrobulbar anaesthetic injection in cataract surgery.
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PMID:Extracapsular cataract extraction under local anaesthesia without retrobulbar injection. 233 40

We prospectively studied 76 patients to analyze the effectiveness of peribulbar anesthesia during strabismus surgery. The patients, ranging in age from 14 to 77 years, were given anesthesia with standard preoperative medication and a peribulbar injection of a mixture of 2% mepivacaine hydrochloride and hyaluronidase. Only one of the 76 patients required an additional injection of anesthetic to achieve adequate anesthesia. No morbidity was associated with the peribulbar anesthesia. Local anesthesia, particularly retrobulbar anesthesia, has been used as an alternative technique in an attempt to reduce the morbidity and mortality associated with general anesthesia in ocular surgery, particularly in those patients with high-risk characteristics. Even with retrobulbar anesthesia, however, there is a risk of morbidity and, in rare cases, mortality. Our results suggest that the use of peribulbar anesthesia is a safe and effective means of anesthesia in strabismus surgery because of minimal associated morbidity.
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PMID:Peribulbar anesthesia for strabismus surgery. 234

In 20 patients, retrobulbar injections of 2 or 5 ml local anesthetic (bupivacaine-lidocaine mixture with hyaluronidase) were given preoperatively. Directly after the 5-ml injection, the systolic retinal and ciliary perfusion pressures (measured by means of oculo-oscillo-dynamography according to Ulrich) were reduced by an average of 5.6 mmHg (p less than 0.001) in comparison with the untreated fellow eyes. The ocular pulsation volume (PVoc) was reduced by 39%. Fifteen minutes after the 5-ml injection, the perfusion pressures and PVoc were reduced even slightly more. The intraocular pressure (Pio) was increased by an average of 3.2 mmHg directly after the 5-ml injection, whereas after 15 min the Pio had reassumed its preinjection level. After the 2-ml injection, the PVoc was reduced by the same amount as found after the 5-ml injection. However, there was no significant change in perfusion pressures or Pio after the 2-ml injection. The findings observed during retrobulbar anesthesia may be interpreted as an inhibitory effect on ocular hemodynamics, which increases at higher injection volumes. This effect cannot be accounted for by adrenaline--which was not employed--and can at best only partially be accounted for by the changes in Pio.
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PMID:[Changes in uveal and retinal hemodynamics caused by retrobulbar anesthesia using various injection volumes]. 262 12


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