Anesthesia, Local Clinical Trial
Official title:
Evaluation of Duration of Anesthesia and Patient Satisfaction After Retrobulbar Block Applied in Cataract Surgery
It is aimed to determine patient satisfaction (pain assessment during and after the operation) and the initial and total anesthesia durations of eye lid and globe anesthesia after administration of local anesthetic solution only in standard applied volumes (1.5-3 ml). No agents will be added to the local anesthetic agents used in the conventional retrobulbar block in patients who will undergo cataract surgery,
In this study, 80 patients with American Society of Anesthesiologists (ASA) I-II-III who
accepted retrobulbar anesthesia before cataract surgery and who were over 18 years of age and
under 90 years of age were included in the study. Not accepting local anesthesia, being under
18 years of age, having problems in communication, having eyelid or eye anomaly, having
Parkinson's disease, myopia with axial length ≥ 26 mm, hypersensitivity to local anesthetics
or other drugs, and bleeding or other drug-induced clotting problem were determined as
exclusion criteria for the investigator's study.
Written informed consent will be obtained from patients eligible for the study according to
the above criteria. While obtaining informed consent, it will also be verbally stated that
this study does not include any risks other than the risks of standard cataract surgery and
retrobulbar block.
Patients taken to the operating room before the operation will be monitored and baseline
blood pressure, pulse and peripheral capillary oxygen saturation (SpO2) values will be
recorded. 2lt / min oxygen will be administered to patients with a nasal cannula. The normal
ocular and valve movements of the patient will be checked and recorded before the procedure.
Patients will receive a 20 gauge intravenous (IV) cannula. Before the retrobulbar block is
applied, topical anesthesia is provided with 0.5% proparacaine drops and field cleaning with
povidone iodine will be performed. The patient will be instructed to look at the finger held
by the assistant personnel to bring the eyeball to the neutral position and the local
anesthetic mixture will be slowly injected into the retrobulbar area with a 25 gauge
ophthalmic needle. For retrobulbar anesthesia, 1.5-3 ml of local anesthetic solution (2%
lidocaine, 5% bupivacaine) will be administered to the patients. The maximum treatment
duration is 1 day and single dose. Gently massage the eye to disperse the local anesthetic
solution and reduce bleeding. After block 1, 3, 5 and 10 minutes ocular movements and valve
movements will be evaluated. To do this, patients will be told to look up, down, right and
left and be asked to squeeze and open their eyelids. Ocular movements will be scored for each
direction separately if normal, 2 if slightly restricted, and 0 if there is no movement
(total score 0-8) [1]. In the evaluation of eye lid movements, complete immobility will be
scored as 0, partial movement as 1 and normal movement as 2 [2]. The patient's blood
pressure, pulse and SpO2 values will be recorded at 5 min intervals throughout the operation.
During the operation, the pain of the patients will be assessed by a 3-point scale (0: no
pain; 1: uncomfortable; 3: pain). Postoperative ocular and eye lid akinesia scores of the
patients will be recorded at 30-minute intervals. Ocular and eye lid akinesia times will be
recorded. Any side effects that occur during and after the procedure will be recorded. One
day later, patients' responses will be recorded by asking for the first time and the number
of times they need analgesics.
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