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Subtenon Block Combined With General Anesthesia for Vitreoretinal Surgery

Phase 3
Completed
Conditions
Subtenon Anesthesia
Interventions
Registration Number
NCT02282774
Lead Sponsor
King Saud University
Brief Summary

To evaluate the effects of subtenon block (SB) as an adjunct to general anaesthesia on postoperative pain, oculocardiac reflex and postoperative nausea and vomiting for vitreoretinal surgery.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Patient undergoing elective retinal surgery under general anesthesia
Exclusion Criteria
  • ASA physical status > Grade II,
  • psychiatric conditions,
  • neurological impairment,
  • deafness with whom communication would be difficult in the postoperative period,
  • clotting abnormalities,
  • contraindications for regional anesthesia,
  • drug abuse,
  • history of allergy to the study drugs,
  • previous vitreoretinal or strabismus surgery,
  • endophthalmitis, or inflammatory eye pathology
  • taking analgesics, antiemetics or drugs that might affect hemodynamics

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SB2% lidocaine and 0.5% bupivacainereceive subtenon block of 4mL of 2% lidocaine and 0.5% bupivacaine (50:50) mixture
CSham subtenon blockreceive subtenon block of 4mL saline
Primary Outcome Measures
NameTimeMethod
the time to first postoperative analgesic dose24 hrs

Pain was evaluated using a VNS chart (0-no pain at all, 10-the worst pain imaginable) at 30 min, 1, 2, 4, 6, 12,18 and 24 hours postoperatively. During PACU stay, if the patient complain of pain postoperatively (VNS ≥ 4), morphine boluses of 25 µg /kg (injected at 10-min intervals) was administered intravenously if requested until the pain subsided for a maximum dose of 10 mg. At the end of 2 h, the patients were transferred from the PACU to the ward where the pain was assessed, paracetamol 15 mg/kg was given intravenously and was repeated every 4 hours if needed in the ward by a nurse who is blinded to the study group as paracetamol is the standard post-operative pain medication for patients undergoing ophthalmic surgery at our institute. Time to first post-operative analgesic, which is the time, elapsed between end of the surgical procedure and first administration of an analgesic was noted

Secondary Outcome Measures
NameTimeMethod
number of patients requiring rescue analgesics during the 24-h study periodduring the whole study (6 months)
postoperative pain scoresFirst 24 hrs after surgery

Pain was evaluated using a VNS chart (0-no pain at all, 10-the worst pain imaginable) at 30 min, 1, 2, 4, 6, 12,18 and 24 hours postoperatively. During PACU stay, if the patient complain of pain postoperatively (VNS ≥ 4), morphine boluses of 25 µg /kg (injected at 10-min intervals) was administered intravenously if requested until the pain subsided for a maximum dose of 10 mg. At the end of 2 h, the patients were transferred from the PACU to the ward where the pain was assessed, paracetamol 15 mg/kg was given intravenously and was repeated every 4 hours if needed in the ward by a nurse who is blinded to the study group as paracetamol is the standard post-operative pain medication for patients undergoing ophthalmic surgery at our institute. Time to first post-operative analgesic, which is the time, elapsed between end of the surgical procedure and first administration of an analgesic was noted.

incidence of postoperative nausea/vomitingFirst 24 hrs after surgery

The incidence of postoperative nausea and vomiting (PONV) was assessed by a nurse (who was blinded to the study drug) for the first 2 h in the PACU and subsequently in the ward at 6, 12 and 24 h and Only 2 possible answers was accepted (yes) or (no). Nausea was defined as subjective sensation of discomfort associated with the awareness of the urge to vomit. Vomiting was defined as a forceful expulsion of gastric contents through the mouth. Rescue antiemetic (Ondansetron 0.15 mg/kg) was given if the patient had persistent nausea or more than a single episode of vomiting or whenever patients request medication and number of patients required rescue anti-emetic postoperatively were recorded

consumption of rescue analgesicsduring the whole study (6 months)

The total number of patients receiving rescue analgesia is recorded

incidence of oculocardiac reflexduring time of surgery

Trial Locations

Locations (1)

King Abdulaziz University Hospital at King Saud University

🇸🇦

Riyadh, Saudi Arabia

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