Abstract
AIMS—A prospective, randomised, double blind study was used to investigate the effect of hyaluronidase on the quality of block achieved with sub-Tenon's local anaesthesia. METHODS—150 patients scheduled for elective cataract surgery were randomly allocated to either sub-Tenon's block with 3 ml lignocaine 2%/adrenaline 1:200 000 alone or with the addition of 30 IU/ml of hyaluronidase. The blocks were assessed for degree of akinesia and reduction of eyelid movement, and also post-injection and postoperative pain scores. RESULTS—Akinesia and reduction of eyelid movement measured 10 minutes after injection were significantly better in the group with hyaluronidase added to the anaesthetic solution. Postoperative pain scores were not significantly different between the two groups but the post-injection pain score was greater (marginally significant) in the group with hyaluronidase added. CONCLUSION—The addition of hyaluronidase significantly improves the quality of the motor blockade achieved with sub-Tenon's local anaesthesia, but has no effect on the sensory blockade.
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Selected References
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- Abelson M. B., Mandel E., Paradis A., George M. The effect of hyaluronidase on akinesia during cataract surgery. Ophthalmic Surg. 1989 May;20(5):325–326. [PubMed] [Google Scholar]
- Bowman R. J., Newman D. K., Richardson E. C., Callear A. B., Flanagan D. W. Is hyaluronidase helpful for peribulbar anaesthesia? Eye (Lond) 1997;11(Pt 3):385–388. doi: 10.1038/eye.1997.81. [DOI] [PubMed] [Google Scholar]
- Crawford M., Kerr W. J. The effect of hyaluronidase on peribulbar block. Anaesthesia. 1994 Oct;49(10):907–908. doi: 10.1111/j.1365-2044.1994.tb04273.x. [DOI] [PubMed] [Google Scholar]
- Guise P., Laurent S. Sub-Tenon's block: the effect of hyaluronidase on speed of onset and block quality. Anaesth Intensive Care. 1999 Apr;27(2):179–181. doi: 10.1177/0310057X9902700209. [DOI] [PubMed] [Google Scholar]
- Hulbert M. F., Yang Y. C., Pennefather P. M., Moore J. K. Pulsatile ocular blood flow and intraocular pressure during retrobulbar injection of lignocaine: influence of additives. J Glaucoma. 1998 Dec;7(6):413–416. [PubMed] [Google Scholar]
- Jay W. M., Aziz M. Z., Green K. Further studies on the effect of retrobulbar epinephrine injection on ocular and optic nerve blood flow. Curr Eye Res. 1986 Jan;5(1):63–67. doi: 10.3109/02713688608995167. [DOI] [PubMed] [Google Scholar]
- Jay W. M., Aziz M. Z., Green K. The effect of retrobulbar epinephrine injection on ocular and optic nerve blood flow. Curr Eye Res. 1985 Jan;4(1):55–58. doi: 10.3109/02713688508999967. [DOI] [PubMed] [Google Scholar]
- Nicoll J. M., Treuren B., Acharya P. A., Ahlen K., James M. Retrobulbar anesthesia: the role of hyaluronidase. Anesth Analg. 1986 Dec;65(12):1324–1328. [PubMed] [Google Scholar]
- Prosser D. P., Rodney G. E., Mian T., Jones H. M., Khan M. Y. Re-evaluation of hyaluronidase in peribulbar anaesthesia. Br J Ophthalmol. 1996 Sep;80(9):827–830. doi: 10.1136/bjo.80.9.827. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sarvela J., Nikki P. Hyaluronidase improves regional ophthalmic anaesthesia with etidocaine. Can J Anaesth. 1992 Nov;39(9):920–924. doi: 10.1007/BF03008340. [DOI] [PubMed] [Google Scholar]
- Stevens J. D. A new local anesthesia technique for cataract extraction by one quadrant sub-Tenon's infiltration. Br J Ophthalmol. 1992 Nov;76(11):670–674. doi: 10.1136/bjo.76.11.670. [DOI] [PMC free article] [PubMed] [Google Scholar]