Monitored anaesthesia care with dexmedetomidine or paracetamol for patients undergoing vitreo-retinal surgeries under sub-tenon’s anaesthesia
Journal Title: International Journal of Medical and Health Research - Year 2018, Vol 4, Issue 8
Abstract
The needleless sub-tenon’s block is being increasingly used for vitreo retinal surgeries. The present study is to evaluate the safety and efficacy of “needleless” regional anaesthesia through the sub-tenon route for vitreo retinal surgery with Dexmedetomidine or Paracetamol infusion as sedation for Monitored Anaesthesia Care (MAC). Methods: Twenty eight patients were included and studied after ethics committee approval. These consented patients were in American Society of Anaesthesiologists physical status I-III of both sexes. They were given 0.75% Ropivacaine through sub-tenon route. Any complication such as intra-ocular pressure rise or orbital haemorrhage were noted. Twenty four hours after the surgery, the patients were asked to grade their pain during postoperative period and was noted on a 10 point visual analog scale. The need for any rescue analgesic was also noted. Patient’s demography, co-morbidities and previous vitreo-retinal surgeries performed were recorded. The haemodynamic stability, respiratory depression or any complication due to technique or medications were also recorded as secondary outcomes. Results: Desired sedation score of 2-3 was effectively achieved with intraoperative infusions of Dexmedetomidine (Group D) and Paracetamol (Group P). Seven patients had marginal hypotension and bradycardia in group D which did not require any active treatment. The duration of postoperative analgesia was significantly prolonged in group D compared with group P as assessed by visual analogue scale. Respiratory depression did not occur in any patient. No adverse events inherent to sedative medication or technique were observed in any patient. Conclusion: Needleless regional anaesthesia appears to be safe and effective and can thus be considered as an alternative to routine peribulbar block for vitreo- retinal cases. The clinical efficacy and safety of Dexmedetomidine was better than Paracetamol in terms of sedation and intraoperative haemodynamic stability without respiratory depression.
Authors and Affiliations
Dr. Shobha Ravishankar
Keywords
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