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 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.
Anaesthesia 1998 May
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.
Anaesthesia 1998 Jun
PMID:Peribulbar anaesthesia using a mixture of local anaesthetic and vecuronium. 1157 32

This is an overview of the biochemistry, biological function and therapeutic uses of hyaluronidase and its substrate, hyaluronate. We focus on the role of hyaluronate and its receptor CD44 in cell-cell and cell-matrix adhesion and cell activation as well as on the putative role of hyaluronate and hyaluronidase in morphogenesis. Variants of CD44 and their putative role in tumor metastasis are also included. Other topics that are discussed are the chemical and enzymatic nature of hyaluronidase, i.e. the mode of substrate degradation, pharmacodynamical and pharmacokinetic aspects of this enzyme and its role as spreading factor. Purification methods, possible contaminations and techniques of activity determinations are mentioned as well as the physiological role of hyaluronidase and tumor-associated alterations in serum and tissue enzyme levels. As far as therapeutic applications are concerned, we discuss uses of hyaluronidase in ophthalmology and regional anesthesia as well as pain management in osteoarthritis using hyaluronate.
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PMID:Hyaluronidase and its substrate hyaluronan: biochemistry, biological activities and therapeutic uses. 983 14

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.
Anaesthesia 1999 Feb
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

In a single centre, randomised, double-blind study, 54 patients underwent intraocular surgery under peribulbar anaesthesia with either ropivacaine 1% or a mixture of bupivacaine 0.75% and lignocaine 2%, both with hyaluronidase 7.5 iu.ml-1. There were no significant differences in volume of anaesthetic required, time to onset of block, peri-operative pain scores or frequency of adverse events between the ropivacaine group and the lignocaine and bupivacaine group.
Anaesthesia 1999 Dec
PMID:A comparison of 1% ropivacaine with a mixture of 0.75% bupivacaine and 2% lignocaine for peribulbar anaesthesia. 1059 16

We compared the efficacy of deep topical fornix nerve block anaesthesia (DTFNBA) versus peribulbar nerve block in patients undergoing cataract surgery using phacoemulsification. We studied 120 patients, allocated randomly to two groups. Group 1 (n = 60) received peribulbar block with 5 ml of a 1:1 mixture of 0.5% plain bupivacaine and 2% lidocaine supplemented with hyaluronidase 300 i.u. ml-1. Group 2 received DTFNBA with placement of a sponge soaked with 0.5% bupivacaine deep into the conjunctival fornices for 15 min. No sedation was given to either group. Analgesia was assessed by the reaction to insertion of the superior rectus suture and by questioning during the procedure. A three-point scoring system was used (no pain = 0, discomfort = 1, pain = 2). Scoring was repeated at keratotomy, hydrodissection and hydrodelineation, phacoemulsification, irrigation and aspiration, and at intraocular lens insertion. If the patient's pain score was 0 or 1, no further action was taken. If the pain score at any stage of the operation was 2, intracameral injection of 1% preservative-free lidocaine was given. One patient in Group 2 needed intracameral lidocaine at the stage of phacoemulsification (P > 0.05) and four experienced discomfort at irrigation and aspiration (P = 0.043). We conclude that DTFNBA may be a useful needle-free anaesthetic technique in patients undergoing cataract surgery using phacoemulsification.
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PMID:Prospective evaluation of deep topical fornix nerve block versus peribulbar nerve block in patients undergoing cataract surgery using phacoemulsification. 1157 11

Vinorelbine tartrate (Navelbine, Burroughs Wellcome Company, Research Triangle Park, NC, USA) is a semisynthetic vinca alkaloid approved in many countries for the first-line treatment of patients with advanced non-small-cell lung cancer. It is also used in the treatment of advanced breast and ovarian cancers and lymphoma. Like other vinca alkaloids, Navelbine can cause skin necrosis as a consequence of inadvertent extravasation in surrounding tissues during intravenous administration. In such cases, early treatment is strongly advocated. There is no documented case of vinorelbine extravasation in the literature. The authors herein report two cases successfully treated with hyaluronidase injections plus saline flushout under local anesthesia.
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PMID:Two case reports of vinorelbine extravasation: management and review of the literature. 1140 Dec 8

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


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