Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A modified retrobulbar block (MRB) using a single superomedial injection was compared with the classical retrobulbar block (RB) and peribulbar block (PB) in a randomized, prospective, surgeon-blinded study involving 150 patients undergoing cataract surgery. No serious complication occurred in any of the patients. The MRB produced higher rates of total akinesia in the orbicularis and all the extraocular muscles, which were statistically significant for the orbicularis, superior, inferior and lateral rectus and oblique muscles when compared with RB, and for the superior rectus and oblique muscles when compared with PB. MRB required less supplemental blocks, provided good operating conditions for the surgeon, and achieved high patient acceptance. It is concluded that MRB is a useful alternative method of ocular block for cataract surgery.
 ...
PMID:A modified retrobulbar block for eye surgery. 828 1

The object of this trial was to determine the efficacy in peribulbar anesthesia of bupivacaine 0.5%, 0.75%, and a combination of bupivacaine 0.5% and lignocaine 2% in equal parts. Fifty-one and 50 patients in random order were injected with 0.5% and 0.75% bupivacaine, respectively, and another 50 patients with the lignocaine/bupivacaine mixture. The results were recorded and all data were statistically analyzed. We concluded that the peribulbar route with the agents used in this trial was not a successful technique. Our criterion for a successful block, i.e., akinesia, was not achieved in more than 54% of cases.
J Cataract Refract Surg 1993 Jan
PMID:Peribulbar anesthesia. A prospective statistical analysis of the efficacy and predictability of bupivacaine and a lignocaine/bupivacaine mixture. 835 71

Small incision self-sealing cataract surgery has created the opportunity to use less invasive anesthesia. One hundred patients were evaluated in a prospective study using a new technique of topical anesthesia to allow small incision construction, intercapsular phacoemulsification, and small incision intraocular lens implantation without a peribulbar or retrobulbar injection. This study demonstrated that topical anesthesia avoids the risk of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye and is effective for intraoperative anesthesia for cataract surgery.
J Cataract Refract Surg 1993 Mar
PMID:Topical anesthesia for small incision self-sealing cataract surgery. A prospective evaluation of the first 100 patients. 945 97

To relieve pain from local anesthetic injections, the authors tried lowering the skin surface temperature by spraying a commercially available cold spray immediately before the injections. A noncontact thermometer was used to measure the thermal change of the skin surface. An esthesiometer was applied to determine the surface perception of the skin. Our basic experiments indicated that there was a relationship between the thermal change and the perception. When the surface temperature dropped to 10 degrees C, there was a definite decrease in the perception. Based on these findings, the authors applied the spray to 100 patients undergoing cataract surgery prior to both akinesia and retrobulbar anesthesia at a distance of 10 cm from the skin surface for 2 seconds, to be immediately followed by the injections. We found the spray to be effective in decreasing the pain due to these injections. Furthermore, there has been no major complications of the spray.
 ...
PMID:Use of cold spray for relieving pain from local anesthetic injections in ocular surgery. 848 14

The single-injection peribulbar technique was performed in 218 patients prior to cataract surgery with les implantation. Peribulbar regional anesthetic block is an effective method of obtaining anesthesia and akinesia. No one case required a reblock or akinesia to perform the surgery safely. There were no major complication associated with the peribulbar technique (one case had to be postponed due to retrobulbar hemorrhage).
 ...
PMID:[Effectiveness of peribulbar anesthesia in anterior eye segment surgery]. 849 Sep 72

This retrospective audit of 87 consecutive patients undergoing routine cataract surgery compared the effect of peribulbar local anaesthesia using 16 mm and 25 mm, 25 gauge needles to administer the anaesthetic. The effect on optic nerve function was observed. There was a significant increase of complete amaurosis in the group where the 16 mm needle had been used. This may be explained by more effective anatomic placement of the 16 mm needle within the orbit, allowing access to the retrobulbar space via fascial septae. There was significantly more lid akinesia with the 16 mm needle. None of this group required an additional facial nerve block, as opposed to 14% of the 25 mm needle group. The use of a 16 mm needle is theoretically safer than a 25 mm needle to administer a peribulbar anaesthetic, in this review it was also demonstrated to be more effective.
 ...
PMID:Peribulbar anaesthesia and needle length. 853 51

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.
 ...
PMID:The role of hyaluronidase on lidocaine and bupivacaine pharmacokinetics after peribulbar blockade. 861 Aug 68

Peribulbar anaesthesia is a useful regional anaesthesia and akinesia technique for eye surgery. We studied changes in muscular akinesia and intraocular pressure under peribulbar anaesthesia caused by different volumes of 0.75% bupivacaine with or without the addition of Thiomucase (chondroitin sulphatase) in patients undergoing cataract surgery. A total of 120 patients were randomly allocated into four groups: group 1, bupivacaine 5 mL; group 2, bupivacaine 5 mL plus Thiomucase 10 U mL-1; group 3, bupivacaine 9 mL; group 4, bupivacaine 9 mL plus Thiomucase 10 U mL-1. We assessed: (1) akinesia according to mobility in the four quadrants of the eyeball and the palpebral opening using a scoring system between 0 (total akinesia) and 10 (full movement); and (2) intraocular pressure before, immediately after and 15 min after peribulbar anaesthesia. A significantly better motor blockade was observed in groups 2, 3 and 4 than in group 1 (P < 0.05). Thiomucase increased the quality of motor blockade in group 2, but not in group 4. Intraocular pressure increased by 5-10 mmHg in comparison with baseline values and, after 15 min application of Honan's balloon, decreased by 8-10 mmHg in comparison with baseline values, with no significant differences between groups. Thiomucase can improve the motor block if a lower volume of local anaesthetic is used. The administration of 5 or 9 mL volumes or the addition of Thiomucase decreases the the intraocular pressure in a similar way.
 ...
PMID:Peribulbar anaesthesia: the role of local anaesthetic volumes and Thiomucase in motor block and intraocular pressure. 866 84

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.
 ...
PMID:Effect of injection pressure on the success rate of peribulbar block. 879 25

Retro- und peribulbar anesthetic injections, the common techniques in cataract surgery, have persistently reported complications. Recently topical anesthesia has been mentioned as a possible alternative. The effectiveness of anesthesia, the acceptance on the part of the patients and the consequences of the lack of akinesia were analysed in a prospective study. We compared two groups of 27 patients. Patients in the first group had only topical anesthesia, while patients in the control group had a peribulbar injection. None of the patients included had such conditions as deafness or dementia or felt overanxious. Both methods were accepted very well by the patients. There were no significant differences in the improvement of visual acuity and the opinion of the patients about pain during the operation. The surgeon's assessment revealed a few cases of increased voluntary eye movements in the topical anesthesia group, but this did not affect the complication rate significantly. There was one case of vitreous loss in each group and in the peribulbar group one case of zonular defect. Topical anesthesia should be seen as an alternative to injection anesthesia.
 ...
PMID:[Eyedrop anesthesia in cataract surgery]. 886 64


<< Previous 1 2 3 4 5 6 7 8 Next >>