| Comparación entre levobupivacaína 0.5% o bupivacaína 0.5%, ambas mezcladas con lidocaína 2% para bloqueo superficial extraconal |
Comparison of levobupivacaine 0.5% or bupivacaine 0.5% both in a mixture with lidocaine 2% for superficial extraconal blockade.
Ahmad N, Zahoor A, Al Assiri A, Al Jastaneiah S, Riad W.
Middle East Afr J Ophthalmol [serial online] 2012 [cited 2012 Jul 3];19:330-3.
Abstract
Purpose: To evaluate the quality and efficacy of Peribulbar blockade for superficial extraconal anesthesia with levobupivacaine 0.5% versus bupivacaine 0.5%, both combined with lidocaine 2% for patients undergoing phacoemulsification. Materials and Methods: In this prospective, double blind study, 150 patients were randomly divided into two groups: group-1 received a Peribulbar block (PB) with a mixture of evobupivacaine 0.5% and lidocaine 2% while group-2 received a PB with a mixture of bupivacaine 0.5% and lidocaine 2%. The block was performed by insertion of a short needle (15 mm) in infra-temporal space just above inferior orbital notch. An initial volume of 6 9 ml of either mixture was injected until total upper eyelid drop. Akinesia score was assessed at 2, 5, and 10 min after the block. The degree of pain was assessed by a verbal rating scale immediately after block, at the end of surgery and 4 h postoperatively. The patients and surgeons were asked to rate their satisfaction level of the quality of block postoperatively. Data were analyzed with the unpaired, two-tailed t-test and the Chi-square test as appropriate. P < 0.05 was considered statistically significant. Results: There were no significant differences between groups with respect to the akinesia score (P = 0.2) at 2, 5, and 10 min, the number of supplementary injections (P = 0.84) and initial and total required volume of local anesthetics (P = 0.80 and 0.81, respectively). There was no significant difference between the groups regarding surgeon and patient satisfaction (P = 0.53 and P = 0.74, respectively). Similarly the verbal rating scales assessed at three different occasions were not significantly different between the groups (P > 0.05 all cases). The need for additional intra-operative topical anesthetic was also similar between the groups. (P = 0.69). Conclusions: Superficial extra-conal block with a mixture of levobupivicaine 0.5% and lidocaine 2% or bupivicaine 0.5% and lidocaine 2% provides similar block quality and efficacy.
Keywords: Levobupivacaine vs. Bupivacaine, Local Anesthesia, Superficial Extraconal Block
http://www.meajo.org/text.asp?2012/19/3/330/97945
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| Anestesia locorregional en oftalmología: una puesta al día |
J. Benatar-Haserfaty, J. A. Puig Flores
Servicio de Anestesiología, Reanimación y Terapia del Dolor. Hospital Universitario Ramón y Cajal. Madrid.
Rev. Esp. Anestesiol. Reanim. 2003; 50: 284-294
Resumen
La anestesia regional oftálmica ha cambiado significativamente en los últimos diez años. El uso de la facoemulsificación para la cirugía de cataratas a través de mínimas incisiones corneales, las lentes plegables y la anestesia tópica simplifican la cirugía de tal forma que la mayoría de los casos se realizan en régimen ambulante. Algunos bloqueos anestésicos son efectuados tanto por anestesiólogos como por oftalmólogos, quienes deben conocer los beneficios y perjuicios que ocasionan en cada paciente. En esta revisión se analizan los aspectos anatómicos de interés para el anestesiólogo, las principales técnicas e innovaciones anestésicas de la especialidad, las complicaciones asociadas y algunos puntos controvertidos como el manejo del paciente que recibe medicaciones que alteran la hemostasia, la retirada de la hialuronidasa en algunos países y la solicitud sistemática de pruebas complementarias antes de la intervención.
Palabras clave:Cirugía: Oftálmica. Técnicas anestésicas: anestesia regional, anestesia retrobulbar, anestesia peribulbar, anestesia tópica, anestesia sub-Tenoniana. Complicaciones: hemorragia orbitaria, perforación ocular, estrabismo, epistaxis.
http://www.sedar.es/vieja/restringido/2003/n6_2003/formacion.pdf
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