అనస్థీషియా & క్లినికల్ రీసెర్చ్
అందరికి ప్రవేశం

నైరూప్య

Dexmedetomidine vs. Fentanyl as Adjuvant to Local Anaesthetic Mixture in Peribulbar Block for Retinal Surgery: A Randomized Prospective Study

Naglaa Khalil and Hesham M Marouf

Background and aims: we aimed to compare the effects of adding dexmedetomidine vs. fentanyl as adjuvants to local anesthetic mixture in peribulbar block for retinal surgery.

Methods: One hundred and thirty adult patients scheduled for retina surgery under peribulbar block were included in this prospective randomized study. The study included 2 groups: Group D received local anesthetic mixture (bupivacaine 0.5%+lidocaine 2%+hyaluronidase 15 IU/mL) plus 20 μg of dexmedetomidine l and Group F received the same local anesthetic mixture plus 20 μg of fentanyl. We observed the onset and duration of sensory and motor block, number of patients needed supplemental local anesthetic injection, volume of anesthetic injected, Ramsay sedation score, visual analogue scale for pain, and adverse events.

Results: Dexmedetomidine group was associated with significantly decreased onset of sensory (1.69 ± 0.64 sec vs. 2.23 ± 0.66 sec) (P<0.05) and motor block (7.23 ± 2.52 sec vs. 8.83 ± 2.10 sec) (P<0.05) and prolonged duration of sensory (162.11 ± 6.66 sec vs. 148.02 ± 5.45 sec) (P<0.05) and motor block (186.97 ± 10.33 sec vs. 157.55 ± 4.38 sec) (P<0.05). Dexmedetomidine group showed significantly higher sedation score for one hour and better postoperative analgesia with significantly lower paracetamol consumption and fewer patients requiring naluphin as rescue analgesia. Number of patients needed supplementary injection and the total injected anesthetic volume were significantly higher in fentanyl group compared to dexmedetomidine group.

Conclusion: Adding Dexmedetomidine to peribulbar block for retinal surgery was superior to adding fentanyl as Dexmedetomidine was associated with better block, more sedation and analgesia, and less analgesic requirement.