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)

Forty-nine patients, ranging in age from 12 to 77 years, underwent strabismus surgery under local anesthesia. With standard preoperative medication and a retrobulbar injection of 2% mepivacaine hydrochloride (hyaluronidase added in 12 patients), effective anesthesia was obtained. Twenty-four patients were observed during the immediate postoperative period, and return of extraocular muscle function and visual acuity was found to be complete an average of 3.8 hours after the injection. The addition of hyaluronidase significantly altered the duration of the anesthetic. Local anesthesia may be a preferable technique in terms of decreased morbidity, especially in the older patient. The short duration of anesthesia and lack of side effects also enable the surgeon to use adjustable sutures and make the final adjustment relatively early in the postoperative period.
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PMID:Retrobulbar anesthesia in strabismus surgery. 647 50

Intramuscular midazolam is better absorbed than when given orally. Addition of hyaluronidase to the injection significantly increases uptake but causes a high incidence of pain at the injection site. Concurrent administration of oral midazolam and metoclopramide does not increase its uptake.
Anaesthesia 1983 Dec
PMID:Intramuscular and oral midazolam. Some factors influencing uptake. 666 Apr 63

The efficacy of low-dose intramuscular ketamine and hyaluronidase as an induction agent was studied in non-premedicated paediatric outpatients. With 40-50% of the hitherto minimum recommended dose a high success rate of induction was achieved, while the recovery time was considered satisfactory for outpatient anaesthesia. Side-effects were minimal and there were no instances of unpleasant dreams or emergence phenomena.
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PMID:Low-dose intramuscular ketamine and hyaluronidase for induction of anaesthesia in non-premedicated children. 740 9

Retrospective chart review (1978-1993) of 179 children less than age 18 (10.0 +/- 3.8 SD yrs) undergoing muscle biopsy for determination of susceptibility to malignant hyperthermia provided data. One hundred and forty-six patients received femoral and lateral femoral cutaneous nerve blocks as their primary anaesthetic. We examined age, weight, duration of surgery, time to discharge from hospital, choice and dosage of local anaesthetics, choice and dosage of sedation, postoperative pain medications, and complications. All children receiving this form of anaesthesia remained outpatients. Between 1978 and 1985 procaine (10 mg.kg-1) with hyaluronidase or 2-chloroprocaine (12 mg.kg-1) provided nerve blockade; after 1985, lignocaine (6.8 mg.kg-1), or a combination of lignocaine or mepivacaine and 2-chloroprocaine, were the preferred agents. More recently the combination of 2-chloroprocaine and bupivacaine has been popular. Three patients required admission to the recovery room postoperatively, due to heavy sedation. Forty-three children (29%) received pain medication during recovery. Femoral and lateral femoral cutaneous block anaesthesia with light to moderate sedation is well tolerated in children undergoing anterior thigh procedures.
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PMID:Femoral and lateral femoral cutaneous nerve block for muscle biopsies in children. 873 22

Although phacoemulsification with only topical anaesthesia is possible, the level of any discomfort perceived by the patient is unknown. Topical anaesthesia eliminates any risk of inadvertent ocular or orbital injury. Twenty-four patients undergoing phacoemulsification under only topical anaesthesia (g. amethocaine 1%) were compared with 23 patients undergoing the same procedure with peribulbar anaesthesia (5 ml lignocaine 2%, 5 ml bupivacaine 0.5% and 75 units hyaluronidase). Perceived pain on administration of the anaesthesia, per-operatively and post-operatively was assessed by a nursing officer using a visual analogue scale (0-10). It was found that there was no difference in pain score between the two groups on induction of anaesthesia. Per-operatively and post-operatively scores were higher in the topical group than in the peribulbar group (p < 0.05, Mann-Whitney U-test), though most of these were within the range 0-3, ('no pain' to 'slight pain'). There was no difference in the amount of analgesia dispensed to the two groups on the ward post-operatively. In conclusion, topical anaesthesia provides adequate anaesthesia for phacoemulsification. Although a small increase in the level of discomfort was observed, the pain levels reported were small and may not be clinically significant when set against the reduced incidence of anaesthetic-related complications.
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PMID:Topical anaesthesia for phacoemulsification surgery. 897 5

Seventy-five patients with senile cataract underwent a planned extracapsular cataract extraction. They were randomly divided into two groups, receiving retrobulbar anesthesia (4 ml lidocaine 2% and 250 IU hyaluronidase) with or without adrenaline. Patients in the adrenaline group had the lowest mean intraocular pressure after the retrobulbar injection (p < 0.02) and they required a shorter time of digital bulbar massage to reduce tension before surgery (p < 0.01). They also appeared to have a deeper anterior chamber during the first part of surgery, although the difference was not statistically significant. The duration of postoperative analgesia was significantly prolonged in patients receiving adrenaline. Different mechanisms explaining the effects of adrenaline in retrobulbar anesthesia are discussed.
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PMID:Retrobulbar anesthesia with and without adrenaline in extracapsular cataract surgery. A prospective, randomized, double-blind study. 762 61

Hyaluronidase, an enzyme that breaks down intercellular cement, has been advocated as an additive to local anesthetics because it allows injected solutions to spread and penetrate tissues. Because epinephrine is commonly used in conjunction with local anesthetics, the combined effects of both hyaluronidase and epinephrine were studied in a prospective, controlled, double-blind manner. The forearms of volunteers ranging in number from 15 to 23 were injected with 0.5 ml of lidocaine to which graded doses of hyaluronidase and epinephrine had been added. At various intervals after injection, the areas of anesthesia were measured. From these data, the time to reach peak area of anesthesia (onset), the size of the peak area of anesthesia, and the time until disappearance of anesthesia (duration) were computed and analyzed. We found that epinephrine has a more profound effect on the onset, area, and duration of anesthesia than hyaluronidase. Epinephrine delayed the time to reach peak area of anesthesia (onset) relative to lidocaine alone more than hyaluronidase (0.28 h versus 0.04 h). When both agents were used together, the effect was subtractive (0.28-0.04 = 0.24 h, compared with 0.22 h observed). This suggests a negative interaction (inhibition) because hyaluronidase decreased the epinephrine effect by 21 percent. Concerning the size of peak area of anesthesia, epinephrine increased the area relative to lidocaine alone more than hyaluronidase (626 versus 221 mm2). When both agents were used together, the effect was additive (626 + 221 = 847 mm2, compared with 848 mm2 observed). This suggests that the two agents acted independently of each other in relation to area of anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of hyaluronidase on local anesthesia: a prospective, randomized, controlled, double-blind study. 770 72

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

The effect of supplementing a standardised local anaesthetic mixture with hyaluronidase was studied in 60 patients undergoing peribulbar block for intra-ocular surgery. All the patients had the block performed with a 2:1 mixture of lignocaine 2% and bupivacaine 0.75%, but in half of the cases hyaluronidase 50 u.ml-1 was added to the solution by random allocation. The mean volumes of solution injected were 8.9 and 9.0 ml in the control and hyaluronidase groups respectively. Five minutes after injection the block was deemed unsuccessful in one third of the patients in each group and these patients required supplementary injections. At 15 min all but one patient in each group had satisfactory block and these two patients subsequently required retrobulbar block. There were no statistically significant differences between the two solutions in rate of onset of block, requirement for supplementation, block failure, or surgical conditions. There were no significant complications. We conclude that the addition of hyaluronidase 50 u.ml-1 to the local anaesthetic mixture described confers no advantage at the volumes of local anaesthetic used.
Anaesthesia 1994 Oct
PMID:The effect of hyaluronidase on peribulbar block. 780 94

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


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