Comparison between dexmedetomidine and neostigmine as an adjuvant to bupivacaine and lidocaine in peribulbar block for cataract surgery.

Mohamed, Samar Ali; Kamal, Hany; Abdelghany, Ahmed; Ali, Mostafa Mahmoud

doi:10.21608/mjmr.2024.262020.1621

Comparison between dexmedetomidine and neostigmine as an adjuvant to bupivacaine and lidocaine in peribulbar block for cataract surgery.

Document Type : Original Article

Authors

¹ Anesthesia and Intensive care department,Faculty of Medicine,El_Minia University

² Anesthesiology and Intensive care department,Faculty of Medicine,Minia University.

³ Ophthalmology department, Faculty of Medicine, Minia University.

⁴ Department of Anesthesiology and Intensive department, Faculty of Medicine, Minia University, Egypt

10.21608/mjmr.2024.262020.1621

Abstract

Abstract:

Background: Local anesthetics are often injected into the peribulbar region. However, using

just local anesthetics is associated with delayed globe akinesia onset, shorter duration of pain

relief, and frequent block reapplication requirements. In comparison to a mix of local

anesthetics.

This research aimed to evaluate the effects of adding dexmedetomidine and neostigmine to

local anesthetic in peribulbar block on hemodynamic of patients and quality of the block.

Study design: A study that is prospective, randomized, and double-blinded.

Methods: Sixty patients were a part of the present study's cohort at Minia University

Hospital. A control group had just a local anaesthetic combination; the other two groups were

of similar size. Patients were randomly assigned to these groups. In the group given

dexmedetomidine, twenty patients were given a dosage of 25µg of the drug in addition to a

mix of local anesthetics. Twenty individuals had a combination of local anesthetics and 0.4

mg of neostigmine as part of the Neostigmine group.

Results: The three groups showed negligible disparities in terms of hemodynamic metrics.

The Dexmedetomidine group exhibited a much faster onset and longer duration of sensory

and motor block in comparison to the other groups. The group that received

dexmedetomidine experienced considerably better levels of satisfaction among both patients

and surgeons.

Conclusion: This research revealed that adding dexmedetomidine or neostigmine to the

local anesthetic mixture improved the quality of the block and patients and surgeon

satisfaction with minimal hemodynamic effects and without changes in the incidence of side

effects.

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