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ORIGINAL ARTICLE
Year : 2017  |  Volume : 34  |  Issue : 1  |  Page : 33-36

Efficacy of adding cisatracurium or rocuronium to the local anesthetic used for peribulbar anesthesia in patient undergoing cataract surgery


1 Department of Anesthesia, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
Reem A Sharkawy
Department of Anesthesia, Faculty of Medicine, Mansoura University, Mansoura, 35516
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-208X.206899

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Objectives The peribulbar block (PBA) has been considered the sole of anesthetic of choice for cataract surgery. But it has a delayed onset of akinesia, which requires large volume of anesthetic solution and higher rate of supplementation when compared with retrobulbar anesthesia. We designed this study to evaluate the benefits of adding rocuronium and cisatracurium to PBA. Patients and methods In total, 60 patients were enrolled in this prospective randomized double-blind study and were subjected to cataract surgery. Patients were randomly divided into three groups equally: the first group (S) received PBA with 4-ml lignocaine 2%, 4-ml bupivacaine 0.5%, and hyaluronidase 30 IU/ml plus 0.5-ml normal saline. The second group (C) patients received 2.5-mg (0.5 ml) cisatracurium added to the standard local anesthetic mixture. The third group (R) patients received 5-mg (0.5 ml) rocuronium added to the standard local anesthetic mixture. The onset and duration of lid and globe akinesia were assessed. Results The onset of lid and globe akinesia was significantly shorter in the cisatracurium group compared with the other two groups (P<0.001). The duration of both lid and globe akinesia was significantly longer in the rocuronium group than in the other groups (P<0.05). Regarding the need for supplementary block, it was lesser in the rocuronium group (5%) than in the cisatracurium group (10%) and the standard group (25%). Conclusion Adding muscle relaxant to the local anesthetic mixture (lidocaine, bupivacaine, and hyaluronidase) for PBA provides optimal globe akinesia, shortens the block onset time, and improves the postoperative analgesia.


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