Subtenon block combined with general anesthesia for vitreoretinal surgery improves postoperative analgesia in adult: a randomized controlled trial.

Autor: Abouammoh MA; Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia. Electronic address: dr.abouammoh@gmail.com., Abdelhalim AA; Department of Anesthesia, Alexandria University, Egypt, Affiliated to King Saud University, Riyadh, Saudi Arabia., Mohamed EA; Department of Anesthesia, National Liver Institute, Menufiya University, Egypt, Affiliated to King Saud University, Riyadh, Saudi Arabia., Elzoughari I; Department of Anesthesia and Intensive Care, Al-Azhar University, Egypt, Affiliated to King Saud University, Riyadh, Saudi Arabia., Mustafa M; Department of Anesthesia, King Saud University, Riyadh, Saudi Arabia., Al-Zahrani TA; Department of Anesthesia, King Saud University, Riyadh, Saudi Arabia.
Jazyk: angličtina
Zdroj: Journal of clinical anesthesia [J Clin Anesth] 2016 May; Vol. 30, pp. 78-86. Date of Electronic Publication: 2016 Mar 15.
DOI: 10.1016/j.jclinane.2015.11.013
Abstrakt: Study Objective: To evaluate the effects of subtenon block (SB) as an adjunct to general anesthesia on intraoperative oculocardiac reflex (OCR), postoperative pain, and postoperative nausea and vomiting (PONV) for vitreoretinal surgery.
Design: Prospective, randomized, double-blinded clinical trial.
Setting: Operating room, postanesthesia care unit, and ward at a university-affiliated hospital.
Patients: Eighty patients aged 40 to 65 years of American Society of Anesthesiologists I to II requesting general anesthesia for vitreoretinal surgery. Intervention and Measurements Patients were randomly assigned to 1 of 2 groups receiving either SB with mixture of 4 mL of 2% lidocaine and 0.5% bupivacaine (50:50) in group SB or subtenon injection of saline in group C after induction of anesthesia and before surgery in a double-blind manner. The time to first postoperative analgesic dose, incidence of intraoperative OCR, postoperative pain scores, perioperative analgesic requirements, number of patients requiring rescue analgesics during the 24-hour study period, incidence of PONV, and possible complications were recorded.
Results: Time to first postoperative analgesia was significantly longer in group SB (P= .002). Pain scores at the first 6 hours postoperatively were significantly lower in group SB (P= .002). Intraoperative and postoperative analgesic requirements were significantly reduced in group SB (P= .015). The incidence of OCR and PONV also significantly decreased in this group (P= .001 and P= .011, respectively).
Conclusion: Use of SB combined with general anesthesia in patients undergoing vitreoretinal surgery reduces postoperative analgesic requirements and complications such as intraoperative OCR and PONV.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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