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Query: UMLS:C0086543 (cataract)
 29,165 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.
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PMID:The effects of volume and speed of injection in peribulbar anaesthesia. 965 24

Medial canthus single injection periocular anesthesia is an alternative technique to classical regional anesthesia techniques for cataract surgery. The occurrence of a chemosis at the end of this injection has made us question ourselves about the real site of injection. The purpose of this anatomic study was to identify this site with precision, and to describe the spreading of the injected solution. Various volumes of colored liquid latex were injected when using this technique on 10 human orbits. They were deeply frozen and sectioned in thin slices. The site of injection is clearly the episceral (sub-Tenon) space. This is a gliding space through which pass the ciliary nerves supplying the globe sensitivity. This could explain the high quality of the analgesia of the globe. With the larger volumes injected, spreading of the latex was detected in the orbicularis palpebra. This probably explains the good akinesia of the lids obtained without any facial block. Spreading of the latex to the rectus muscles sheaths should explain the good akinesia of the globe, but was only partially proved in this study. We conclude that the medial canthus single injection periocular anesthesia is an episcleral (sub-Tenon) injection which may explain good anesthesia.
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PMID:Medial canthus episcleral (sub-Tenon) anesthesia imaging. 980 Sep 18

The Greenbaum's technique of parabulbar anaesthesia was used to deliver 2% lignocaine with 1:200,000 adrenaline in 44 patients undergoing anterior segment types of procedures. These consisted of 22 intracapsular cataract extraction, 7 extracapsular cataract extraction and lens implant, 1 lens aspiration, 6 trabeculectomies, 1 combined trabeculectomy and extracapsular cataract extraction, 2 prolapsed iris, 2 corneal laceration, 2 hyphaema evacuation, and 1 retinal cryopexy. Three children and 41 adults were included in the study. Onset of anaesthesia was rapid and effective. Though akinesia was not always complete the surgery was always manageable. Almost all the patients had painless surgery. With this method there is virtually no risk of serious complications that may be encountered in retrobulbar and peribulbar anaesthesia such as retrobulbar haemorrhage, globe penetration and perforation, optic nerve damage, and injection into the subarachnoid space. This method is simple, safe, and effective.
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PMID:Evaluation of Greenbaum's anaesthetic technique using lignocaine with adrenaline. 981 81

This technique is a safe simple way to administer sub-Tenon's anesthesia that provides akinesia comparable to that of retrobulbar and peribulbar anesthesia and frequently results in excellent lid block. The potentially serious complications associated with retrobulbar and peribulbar methods appear to be absent.
J Cataract Refract Surg 1999 Jan
PMID:Simplified sub-Tenon's anesthesia: miniblock with maxiblock effect. 988 71

A prospective, randomised, double-blinded study comparing three agents for peribulbar anaesthesia is reported. Sixty patients undergoing extracapsular cataract extraction under local anaesthesia were randomly allocated to receive peribulbar anaesthesia with lignocaine 2% with adrenaline; prilocaine 3% with felypressin 0.03 IU.ml-1 or 2% lignocaine and 0.5% bupivacaine in a ratio of 1:1, using a standardised two-injection technique. The pain of injection, time of onset of the block and the operating conditions at the start and finish of surgery were assessed. Peribulbar anaesthesia using lignocaine 2% was significantly more painful than the other solutions. The onset of anaesthesia adequate for surgery was similar in all three groups. Prilocaine 3% with felypressin was associated with the greatest number of blocks providing total akinesia of the eye. Inadequate duration of anaesthesia was seen in only one case; the solution used for this block was 2% lignocaine.
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PMID:Peribulbar anaesthesia: a double-blind comparison of three local anaesthetic solutions. 1020 73

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

A prospective, observer blinded study on 51 patients undergoing cataract surgery was conducted to assess Total Upper Eyelid Drop as a new end-point marker to single injection peribulbar block. At present, no such clinical marker exists to stop clinicians injecting more than necessary volumes of local anaesthetic and therefore to prevent dangerous increases in intra-ocular pressure. Using this technique, satisfactory ocular akinesia was achieved in 90% of eyes 10 min after injection. Operating conditions were satisfactory in 98% of cases. The mean (range) volume injected was 9.1 (4-15) ml. The mean increase in intra-ocular pressure immediately after injection was 6.9 mmHg, decreasing to 0.7 mmHg after 5 min without the application of ocular compression. We found a negative correlation between the increase in intra-ocular pressure and the volume of injection (p < 0.002), which has never previously been reported. We conclude that Total Upper Eyelid Drop is a reliable endpoint marker for producing satisfactory operating conditions for cataract surgery while minimising increases in intra-ocular pressure and its use may therefore avoid the risks associated with ocular compression.
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PMID:Single injection peribulbar anaesthesia. Total upper eyelid drop as an end-point marker. 1135 Mar 66

This study evaluated the efficacy and side-effects of plain ropivacaine compared with ropivacaine-lidocaine and bupivacaine-lidocaine mixtures for peribulbar blocks in cataract surgery. Ninety patients were randomly allocated to three groups and received peribulbar blockade using one of the three solutions. Speed of onset and quality of blockade were assessed using akinesia, surgical satisfaction and patient satisfaction. Complications and cardiovascular side-effects were noted. There was a slower onset of akinesia using ropivacaine alone, although at 10 min after injection all groups were equal in this respect. There was no difference in surgical or patient satisfaction between the groups. There were no differences in pain on injection, preblock and postblock blood pressure, heart rate or oxygen saturation. The optimal time to surgical incision after peribulbar blockade is not less than 15 min and plain ropivacaine fulfils this criterion.
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PMID:A double-blind randomised comparison of ropivacaine 0.5%, bupivacaine 0.375% - lidocaine 1% and ropivacaine 0.5% - lidocaine 1% mixtures for cataract surgery. 1101 97


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