Dexmedetomidine Versus Dexamethasone as an Additive to Local Anesthetic Mixture in Peribulbar Block in Cataract Surgeries

Dexmedetomidine Versus Dexamethasone as an Additive to Local Anesthetic Mixture in Peribulbar Block in Cataract Surgeries

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.

Inclusion Criteria:

• Age: > 18 years old.
• Sex: Male & Female
• American Society of Anesthesiologists (ASA) Physical status I -III.
• Patients undergoing ophthalmic surgery under local anesthesia.

Exclusion Criteria:

• Patients' refusal.
• Patients have active ocular infection.
• Patients have single eyes.
• Allergy to thesis medications (mainly bupivacaine and lidocaine).
• Patients cannot lie flat.
• Patient on anticoagulation.
• Abnormal coagulation profile in the form of international normalized ratio (INR) ≥1.6