Vol. 83, March 2015

The Effect of Addition of Rocuronium to Local Anesthetic in Peribulbar Block for Cataract Surgery, HOSSAM M. ATEF, ALAA EL-DIN M. EL-KASSABY, MAGDY A. OMERA and AMR K. ABDEL GAWAD

User Rating:  / 0
PoorBest 

The Effect of Addition of Rocuronium to Local Anesthetic in Peribulbar Block for Cataract Surgery, HOSSAM M. ATEF, ALAA EL-DIN M. EL-KASSABY, MAGDY A. OMERA and AMR K. ABDEL GAWAD

 

Abstract
Introduction: There are a limited number of studies that compared Rocuronium as additive to local anesthetic mixture in cataract surgery using peribulbar technique; but none of these studies evaluated the duration of block.
Purpose: To evaluate the effects of adding Rocuronium (5mg) to local anesthetic mixture on akinesia of globe and eyelid regarding onset and duration in cataract surgery using peribulbar technique.
Methods: This study was carried out as a single blind randomized clinical trial. Sixty patients were randomly as-signed to one of study groups; the first group (control group) received local anesthetic 3.5ml 2% Lidocaine+3.5ml 0.5% plain Bupivacaine+0.5ml saline 0.9%, the second group (Rocuronium group) received local anesthetic 3.5ml 2% lidocaine+3.5ml 0.5% plain Bupivacaine+0.5ml Rocuronium (5mg).
Results: Regarding the onset of lid movement measured at 3 minutes in Rocuronium group only 2 patients (6.67%) of the group showed complete lid akinesia and 16 patients (53.33%) showed flickering, representing statistically signif-icant difference between Rocuronium and control groups. Rocuronium group demonstrated significantly better lid aki-nesia scores than control group at 5 and 10 minutes post injection.
There was statistically significant difference in onset of globe movement at 1 minute with Rocuronium group versus control group, as 8 patients in Rocuronium group (26.67%) show partial akinesia. At 3 minutes, 5 patients of Rocuronium group (16.67%) showed complete akinesia which statistically significant difference and 20 patients of Rocuronium group (66.67%) versus 5 patients of control group (16.67%) had partial akinesia. Also Rocuronium group demonstrated signif-icantly better globe akinesia scores than control group at 5 and 10 minutes post injection. Four patients in Rocuronium group (13.33%) and versus 12 patients (40%) required a supplementary injection 10 min after block because of inad-equate motor block (akinesia score >4) and the difference was statistically relevant (p=0.03).
Duration of globe akinesia was (122.5±9.72) in Rocuro-nium group versus control group (91.5±9.11) showed highly statistical significant difference (p=0.001). No difference in pain scores noted intraoperative or postoperative follow-up for two hours. No systemic or ocular adverse effects were recorded in any group.
Conclusion: The addition of low dose rocuronium 5mg to local anesthetic solution shortens the onset time, prolongs the duration of akinesia and reduces the need for supplementary injections without known complications.

 

Show full text

Copyright © 2014. All Rights Reserved.
Designer and Developer 
EXPERT WEB SOLUTIONS        0020 1224757188