TY - JOUR
T1 - Influence of infusion volume on the ocular hemodynamic effects of peribulbar anesthesia
AU - Lung, Solveig
AU - Luksch, Alexandra
AU - Weigert, Günther
AU - Georgopoulos, Michael
AU - Menapace, Rupert
AU - Polska, Elzbieta
AU - Garhofer, Gerhard
AU - Findl, Oliver
AU - Schmetterer, Leopold
PY - 2006/9
Y1 - 2006/9
N2 - Purpose: To test the hypothesis that ocular blood-flow response to peribulbar anesthesia can be reduced by using a smaller volume of anesthetic mixture. Setting: Departments of Ophthalmology and Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. Methods: Twenty patients scheduled for bilateral age-related cataract surgery were enrolled in a prospective randomized balanced observer-masked crossover study. Two study days with a 2 mL injection volume or 5 mL injection volume used for peribulbar anesthesia were scheduled. On 1 study day, patients received the 1-dose regimen and on the other study day, when the contralateral eye had surgery, patients received the other injection volume. On both study days, the anesthetic mixture consisted of an equal amount of lidocaine, bupivacaine, and hyaluronidase independently of the injection volume. Intraocular pressure (IOP), blood pressure, and pulse rate were measured noninvasively. Ocular fundus pulsation amplitude (FPA) and peak systolic and end diastolic flow velocities in the central retinal artery were measured with laser interferometry and color Doppler imaging, respectively. The results were recorded as means ± SD. Results: Peribulbar anesthesia increased IOP and reduced FPA and flow velocities in the central retinal artery. The effects on IOP (5 mL, 35.1% ± 16.0%; 2 mL, 14.1% ± 14.1%; P<.001) and ocular hemodynamic parameters (FPA: 5 mL, -17.5% ± 7.8%/2 mL, -7.3% ± 7.2%, P<.001; peak systolic velocity: 5 mL, -19.5% ± 10.7%/2 mL, -10.6% ± 9.8%, P = .013; end diastolic velocity: 5 mL, -16.7% ± 6.2%/2 mL, -8.4% ± 7.3%, P = .005) were more pronounced with the 5 mL injection volume than with the 2 mL injection volume. Conclusions: An injection volume of 2 mL instead of 5 mL reduced the ocular blood-flow response to peribulbar anesthesia. This procedure may be used in patients with ocular vascular disease to reduce the incidence of anesthesia-induced ischemia and loss of vision.
AB - Purpose: To test the hypothesis that ocular blood-flow response to peribulbar anesthesia can be reduced by using a smaller volume of anesthetic mixture. Setting: Departments of Ophthalmology and Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. Methods: Twenty patients scheduled for bilateral age-related cataract surgery were enrolled in a prospective randomized balanced observer-masked crossover study. Two study days with a 2 mL injection volume or 5 mL injection volume used for peribulbar anesthesia were scheduled. On 1 study day, patients received the 1-dose regimen and on the other study day, when the contralateral eye had surgery, patients received the other injection volume. On both study days, the anesthetic mixture consisted of an equal amount of lidocaine, bupivacaine, and hyaluronidase independently of the injection volume. Intraocular pressure (IOP), blood pressure, and pulse rate were measured noninvasively. Ocular fundus pulsation amplitude (FPA) and peak systolic and end diastolic flow velocities in the central retinal artery were measured with laser interferometry and color Doppler imaging, respectively. The results were recorded as means ± SD. Results: Peribulbar anesthesia increased IOP and reduced FPA and flow velocities in the central retinal artery. The effects on IOP (5 mL, 35.1% ± 16.0%; 2 mL, 14.1% ± 14.1%; P<.001) and ocular hemodynamic parameters (FPA: 5 mL, -17.5% ± 7.8%/2 mL, -7.3% ± 7.2%, P<.001; peak systolic velocity: 5 mL, -19.5% ± 10.7%/2 mL, -10.6% ± 9.8%, P = .013; end diastolic velocity: 5 mL, -16.7% ± 6.2%/2 mL, -8.4% ± 7.3%, P = .005) were more pronounced with the 5 mL injection volume than with the 2 mL injection volume. Conclusions: An injection volume of 2 mL instead of 5 mL reduced the ocular blood-flow response to peribulbar anesthesia. This procedure may be used in patients with ocular vascular disease to reduce the incidence of anesthesia-induced ischemia and loss of vision.
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U2 - 10.1016/j.jcrs.2006.04.024
DO - 10.1016/j.jcrs.2006.04.024
M3 - Article
C2 - 16931264
AN - SCOPUS:33747354138
SN - 0886-3350
VL - 32
SP - 1509
EP - 1512
JO - Journal of Cataract and Refractive Surgery
JF - Journal of Cataract and Refractive Surgery
IS - 9
ER -