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This study aimed to compare the effects of dexamethasone and dexmedetomidine when added to a local anesthetic mixture for peribulbar block in patients undergoing elective anterior segment eye surgery.
Regional block (especially peribulbar block) is the preferred choice of anesthesia for many ophthalmic surgeries as it has less complications. Peribulbar block with local anesthetics only lead to delayed onset corneal anesthesia and globe akinesia, and frequent need of block supplementation.
Dexmedetomidine is a drug which belongs to alpha 2 adrenergic receptor agonist. It provides several desirable effects, including sedation, anxiolysis, analgesia, and a reduction in intraoperative opioid requirements, when used as an adjuvant to local anesthetics, dexmedetomidine has been shown to prolong the duration of sensory and motor blocks, improve hemodynamic stability, and enhance overall patient satisfaction.
Dexamethasone, a synthetic corticosteroid, the use of dexamethasone as an additive in peribulbar blocks has been shown to improve the quality of anesthesia, reduce the need for supplemental intraoperative analgesics, and decrease postoperative pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A | Experimental | Patients received 20 μg of dexmedetomidine in 1 ml solution. |
|
| Group B | Experimental | Patients received 4 mg dexamethasone in 1 ml solution. |
|
| Group C | Active Comparator | Patients received 1 ml normal saline. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine | Drug | Patients received 20 μg of dexmedetomidine in 1 ml solution. |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Time for first request of the rescue analgesia | Time for first request of the rescue analgesia was recorded from the end of surgery till first dose of morphine administrated. | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative opioid consumption | If the Visual analogue score (VAS) was >4, a 0.1 mg/kg bolus dose of intravenous morphine will be administered if no response the bolus dose will be repeated with a maximum dose of 10 mg. | 12 hours postoperatively |
| Degree of patient satisfaction |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Helwan University | Helwan | 11795 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Dexamethasone |
| Drug |
Patients received 4 mg dexamethasone in 1 ml solution. |
|
| Normal saline | Drug | Patients received 1 ml normal saline. |
|
Degree of patient satisfaction was assessed on a 4-point scale (1, excellent; 2, good; 3, fair; 4, poor). |
| 24 hours postoperatively |
| Degree of pain | Each patient was instructed about postoperative pain assessment with VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS was recorded , 2, 4, 8, and 12 hours postoperatively. | 12 hours postoperatively |
| Heart rate | Heart rate was measured before and after the peribulbar injection (baseline) (5,10, 15, 30, 45, 60, 90 till 120 min) the each 6 hours for 12 hours postoperatively. | 12 hours postoperatively |
| Mean arterial blood pressure | Mean arterial blood pressure was measured before and after the peribulbar injection (baseline) (5,10, 15, 30, 45, 60, 90 till 120 min) the each 6 hours for 12 hours postoperatively. | 12 hours postoperatively |
| Intraocular pressure | Intraocular pressure (IOP) was measured 30 min before injection of the local anesthetics as a baseline reading. The other reading 10 min after injection of local anesthetics. | 10 min after injection of local anesthetics |
| ID | Term |
|---|---|
| D020927 | Dexmedetomidine |
| D003907 | Dexamethasone |
| D000077330 | Saline Solution |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D011246 | Pregnadienetriols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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