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首页> 外文期刊>The Open Anesthesia Journal >Dexmedetomidine was Better at Lowering Intraocular Pressure than Magnesium when Combined with Local Anesthetics in Peribulbar Blocks for Posterior Segment Eye Surgery
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Dexmedetomidine was Better at Lowering Intraocular Pressure than Magnesium when Combined with Local Anesthetics in Peribulbar Blocks for Posterior Segment Eye Surgery

机译：当在眼球后段眼球手术中结合局麻药联合局部麻醉药时，右美托咪定在降低眼压方面比镁更好

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Background and Aim: Many medications are combined with local anesthetics for peribulbar blocks to improve the quality of the block, however, few studies have compared the effect of dexmedetomidine and magnesium on intraocular pressure when combined with local anesthetics which was the primary endpoint of this double blinded study. Materials and Methods: A randomized controlled clinical trial was conducted on 60 ASA Physical Status (ASA PS) I-II patients scheduled for elective posterior segment eye surgeries under peribulbar anesthesia. Patients were randomly allocated to one of three groups of 20 each according to the medications they received. Local anesthetic solution was prepared using 8 ml of bupivacaine 0.5% and lidocaine 2% in a 1:?1 ratio plus 1ml of hyaluronidase (150 units) making a total volume of 9 ml: Group D received: local anesthetic + 20 μg dexmedetomidine diluted with 1 mL of normal saline. Group M received: local anesthetic + magnesium sulphate 50 mg in 1 ml normal saline. Group C received local anesthetic + 1 ml normal saline. Intraocular pressure was measured with the Perkins applanation tonometer immediately before injection and at 1, 5, 10, 15 minutes (min) after injection and then at the end of the procedure, the onset and duration of lid and globe akinesia were assessed. Postoperative analgesia and the first dose of analgesic medication were also assessed. Results: Intraocular pressure measurements were statistically lower in group D than the other two groups at 10 and 15mins. The onset of globe and lid akinesia was the most rapid in Group D compared to the other two groups. The duration of globe and lid akinesia was the longest in group D. Time to first analgesic dose request was significantly longer in group D followed by group M then group C. Visual analogue score for pain was significantly less between group D and other two groups. There were no episodes of hypotension or bradycardia in the three groups. No side effects or complications as hemorrhage, globe perforation, brain stem anesthesia sedation were observed. Conclusion: In our study addition of dexmedetomidine to a peribulbar block was statistically better at reducing IOP, increasing the duration of optic anesthesia and delaying the need for postoperative analgesic dose request than magnesium.
机译：背景与目的：许多药物与眼球周围阻滞剂配合使用局部麻醉剂以改善阻滞剂的质量，但是，很少有研究比较右美托咪定和镁与局部麻醉剂联合使用对眼压的影响，这是双重麻醉的主要终点。盲目的研究。材料和方法：随机对照临床试验针对60名ASA物理状态（ASA PS）I-II患者进行，这些患者计划在球周麻醉下进行择期后段眼科手术。根据患者所接受的药物，将患者随机分为三组，每组20组。使用8 ml 0.5％布比卡因和2％利多卡因（按1：？1比例）加1ml透明质酸酶（150单位）制备局部麻醉液，使总体积为9 ml：D组：局麻药+ 20μg右美托咪定稀释用1毫升生理盐水。 M组接受：1毫升生理盐水中的局部麻醉药+硫酸镁50毫克。 C组接受局部麻醉药+ 1 ml生理盐水。在注射前和注射后1、5、10、15分钟（min），然后在手术结束时，用Perkins压平眼压计测量眼压，然后评估眼睑和球囊运动障碍的发作和持续时间。还评估了术后镇痛和止痛药的首剂剂量。结果：D组在10分钟和15分钟时的眼压测量值在统计学上低于其他两组。与其他两组相比，D组中球囊和眼睑运动障碍的发作最快。 D组中球囊和眼睑运动障碍的持续时间最长。D组，M组和C组的首次镇痛剂量要求时间明显更长。D组与其他两组之间的视觉疼痛类似评分明显更低。三组均无低血压或心动过缓发作。没有观察到出血，球形穿孔，脑干麻醉镇静等副作用或并发症。结论：在我们的研究中，与镁相比，右美托咪定添加至球周阻滞在降低IOP，增加视神经麻醉的持续时间和延迟术后镇痛剂量要求方面具有统计学上的优势。

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