EFFICACY OF ADDITION OF MAGNESIUM AS AN ADJUVANT TO LOCAL ANAESTHETICS IN PERIBULBAR BLOCK: A PROSPECTIVE RANDOMIZED DOUBLE-BLIND STUDY

Abstract

Introduction: Topical, regional or general anesthesia can be used for ocular surgery. Among regional blocks, Peribulbar block is a good choice as it provides efficient anesthesia with good lid and globe akinesia with low incidence of complications.1 However the time for onset of akinesia with Peribulbar block is much longer in comparison to retro bulbar block,2which may lead to a delay to start the surgery. The incidence of inadequate analgesia is also more frequent with Peribulbar block2 in comparison to retro bulbar block, which may lead to the requirement of supplementary injection before the start of surgery or intraoperatively. Aims And Objectives: To evaluate the effect of addition of magnesium sulphate to standard local anesthetics mixture for peribulbar blocks in ophthalmic surgeries. Material And Methods: 60 patients who underwent ocular surgery under local anesthesia admitted at Malla Reddy Narayana Multispecialty Hospital, Hyderabad from May2018- october2018(6 months) were enrolled in the study.It was Prospective Randomized controlled double blind study.Inclusion criteria was patients between 20-70 years of either sex with ASA group 1-3 with both anterior and posterior chamber surgery under peribulbar block.Exclusion criteria were patient with mental retardation, allergic to local anesthetics, history of bleeding disorder, cardiac and respiratory diseases and ASA group4-5. Results: After studying 60 patients, out of which 30 patients included in control group (Group NS) and 30 patients in study (Group MS) group,a systematic statistical analysis done for Age and All patients were in age group of 20-70 years. Mean age was 59.0667 +- 7.08049 in the control group (Group NS) and 58.1667 +- 5.73605 in study group (Group MS). The p-value 0.591,which is statistically nonsignificant. Discussion:Anaesthesia plays a vital role in ophthalmic surgery.Most ophthalmic surgeries are carried out under local anaesthesia although topical anaesthesia is soon gaining popularity.The goal of anaesthesia in opthalmic surgery is to provide adequate analgesia and akinesia.Peribulbar block has been used widely for ophthalmic surgery as it is safer than a retrobulbar block. The time for onset of akinesia with peribulbar block is much longer in comparison to retrobulbar block2, which may lead to a delay to start the surgery.The incidence of inadequate analgesia is also more frequent with peribulbar block2 in comparison to retrobulbar block, which may lead to the requirement of supplementary injection before the start of surgery or intraoperatively. Conclusions: Faster onset of globe and lid akinesia after addition of Magnesium sulphate to the mixture of local anaesthetics in peribulbar block.The duration of globe and lid akinesia is prolonged but difference is not statistically significant in Group MS as compared to Group NS.