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

To test the hypothesis that rocuronium added to a mixture of local anaesthetics could improve akinesia in Peribulbar Block (PB) we designed this prospective, randomized, double-blinded study. Sixty ASA physical status I and II patients presenting for cataract surgery (manual extracapsular lens extraction) under PB were included. Patients were randomized to 2 groups: rocuronium group (n = 30) received PB with a local anesthetic mixture (Lidocaine 2% + Bupivacaine 0.5%) to which was added 0.06 mg/Kg of rocuronium and control group (n = 30) received PB with the same mixture to which was added saline. Akinesia was assessed with a 12-point scale at 2, 5 and 10 minutes after injection (each of the four rectus muscles and each lid was scored from 0 to 2; 0 = total akinesia, 1 = partial akinesia, 2 = no akinesia). The need for supplementary injection, adverse effects and complications were also recorded. Rocuronium group demonstrated significantly better akinesia scores than control group at 2, 5 and 10 minutes post PB (p < 0.05). Supplementary injection was necessary in 4 patients (13%) in rocuronium group versus 12 patients (40%) in control group (p = 0.039). No significant complications were recorded. Rocuronium added to a mixture of local anaesthetics at a dose of 0.06 mg/Kg improved the quality of akinesia in PB and reduced the need for supplementary injections.
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PMID:Effect of the addition of rocuronium to local anesthetics for peribulbar block. 2115 37

Peribulbar anesthesia is widely applied in cataract surgeries. The aim of this study was comparing the effect of using Atracourium, cis-Atracourium, and placebo as adjuvant agents to the local anesthetic substance on peribulbar-induced akinesia in cataract surgeries. The study was double-blind randomized clinical trial, among the patients candidate for the cataract surgery who were hospitalized in ocular surgery ward in Farabi Hospital between 2006 and 2007. 90 patients were subcategorized into 3 groups randomly. Group I received a mixture (8 ml) containing equal parts of Marcaine 0.5%, Lidocaine 2% and Hyaluronidase 90 IU plus 0.5 ml normal saline; group II received the mixture (8 ml) plus 0.5 ml Atracourium 5 mg, and group III received the mixture (8 ml) plus 0.5 ml cis-Atracurium with the help of peribulbar blockage technique. The score of akinesia were evaluated in the 1st, 3rd, 5th, 10th minutes after administration of the medications. 10 minute after drug administration, 25 (92.6%) reached the total akinesia with Atracourium, 23 (85.2%) with cis-Atracourium, and 23 (85.2%) with the placebo (P>0.05). Addition of low-dose Atracourium and cis-Atracourium to the anesthetic drug is recommended in order to accelerate the onset of akinesia resulted by the peribulbar block, and in order to enhance the quality of akinesia especially when Hyaloronidaze is not added.
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PMID:Comparing the effect of using atracourium and cis-atracourium as adjuvant agents to the local anesthetic substance on peribulbar-induced akinesia. 2200 5

It has been reported that alkalinisation of an anaesthetic medication enhances the rate of onset of regional anaesthesia. The purpose of this study therefore was to find out whether alkalinisation really hastened peribulbar anaesthesia as given prior to routine cataract surgery. Two hundred and forty otherwise healthy patients with bilateral cataracts were selected for this study irrespective of their demographic attributes. The first eye (group FE) received a routine peribulbar block with a standard solution of 6 ml of 2% lignocaine mixed with 15 IU/l units of sodium hyaluronidase at a pH of 4.6. The second eye (group SE) was taken up for surgery after one week and received a peribulbar block with 6 ml lignocaine 2% mixed with 7.5% sodium bicarbonate at a pH 7.4. The time taken for onset of akinesia in both the situations was measured to the last minute with the aid of a stop watch by an independent observer. Thirty-five per cent of patients in group FE had complete akinesia at the end of 5 minutes, another 60% at the end of 7 minutes and remaining 6% at 10 minutes. Sixty-eight per cent of patients in group SE had complete akinesia at the end of 5 minutes and 100% at the end of 7 minutes. No anaesthesia related ocular or systemic complications were seen in any group. Sodium bicarbonate buffered peribulbar block is faster than routine hyaluronidase augmented block with a reduced time of onset of akinesia.
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PMID:Sodium bicarbonate versus sodium hyaluronidase in ocular regional anaesthesia--a comparative study. 2302 28

Commonly used anesthetic techniques for cataract surgery include peribulbar and sub-Tenon anesthesia. This evidence-based review compares these techniques, with a particular focus on patient comfort, akinesia, and anesthetic complications. A systematic search of the literature revealed that there is a paucity of robust evidence comparing sub-Tenon and peribulbar anesthesia. Based on the best available evidence, there is no significant difference in the efficacy of peribulbar compared with sub-Tenon anesthesia for cataract surgery; however, the potential complications of peribulbar anesthesia are more serious.
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PMID:Systematic Review of Peribulbar Anesthesia Versus Sub-Tenon Anesthesia for Cataract Surgery. 2610 35

A 17-year-old male presented with gradual painless diminution of vision since childhood. Slit lamp examination revealed both eyes having congenital cataract. Right eye lens aspiration was performed but was uneventful, and he prepared for left eye surgery after 7 days. Immediately after giving a peribulbar block, a complete akinesia, tight eyelids, and stony hard eyeball was noted. An abaxial proptosis of 7 mm was noted. Lateral canthotomy and inferior cantholysis were done and proptosis reduced to 5 mm. Bleeding time-clotting time was normal. Proptosis worsened to 8 mm the next day. Contrast-enhanced computed tomography scan showed inferolateral subperiosteal hematoma, but drainage could not be performed due to prolonged prothrombin time and activated prothrombin time. Fresh frozen plasma was transfused. Tarsorrhaphy was performed for exposure keratopathy after his coagulation profile became normal. Hematology evaluation after 2 weeks detected factor V deficiency, and was diagnosed as Owren's disease or parahemophilia.
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PMID:Subperiosteal hematoma from peribulbar block during cataract surgery leading to optic nerve compression in a patient with parahemophilia. 2666 47

Peribulbar block is used to obtain anaesthesia and akinesia of the eye by injecting a local anaesthetic around the musclecone. A patient scheduled for cataract surgery received peribulbar block with 6 mL of 2% lidocaine hydrochloride. Following the injection, confusion, hypotension and dilatation of the contralateral pupil rapidly progressed to loss of consciousness and respiratory arrest. The patient was intubated and mechanically ventilated for 30 min. The patient regained her consciousness, was extubated and transferred to the intensive care unit for further follow-up. Although brainstem anaesthesia because of peribulbar block is very rare, this procedure should be performed with complete monitorisation and resuscitation equipment.
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PMID:Complication of Peribulbar Block: Brainstem Anaesthesia. 2886 71


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