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Introduction: Cataract surgery is performed under peribulbar or retrobulbar block. Majority of the patients posted for cataract have some form of medical diseases like diabetes, hypertension, angina, ischaemic heart disease etc. Lidocaine and bupivacaine are the most commonly used local anesthetic for the block procedure. Here we compare the efficacy of peribulbar block in cataract surgery using the combination of 1:1 mixture of 2% lidocaine with 0.5% bupivacaine and 1:1 mixture of 2% lidocaine with 0.75% ropivacaine. Materials and Methods: It is a prospective, randomized, double blinded study including 60 patients were devided into two groups of 30 each, Group-R received 8 ml of 1:1 mixture of 4 ml of 2% lidocaine, 4 ml of 0.75% ropivacaine and 15 IU/ml of hyaluronidase and group-B received 8 ml of 1:1 mixture of 4 ml of 2% lidocaine, 4 ml of 0. 5% bubivacaineand 15 IU/ml of hyaluronidase. Peribulbar block was performed as per Bloomberg's modification of the Davis and Mandel technique where 5 ml of local anesthetic was injected in the infero temporal region and 3 ml of drug was injected in the superi nasal area. Patients were assessed for sensory block, eyelid and occular movements at an interval of 2 minutes. Systolic, diastolic and mean arterial pressures, heart rate, oxygen saturation, ECG were monitored non invasively at 1,3,5,8,10,15 and then every 10 minutes till the end of the surgery. Observation and Discussion: Mean time for the onset of sensory blockade was 2.70 ± 6.5 minutes in Group B and 2.63 ± 0.57 minutes in group R with P-value 0.671, showing no significant difference in the onset of sensory blockade. Onset of motor blockade was 6.53 ± 1.81 minutes in group B, and 7.57 ± 1.46 minutes in the group R, the P-value being 0.018 was statistically significant. Regarding the duration of analgesia, our study showed mean time for analgesia lasted for 295 ± 54.63 minutes in group B and 414.67 ± 99.47 in group R with P value 0.001 showing statistically significant prolongation of duration of analgesia with group R. We observed a significant increase of mean IOP in bupivacaine group from 13.333 ± 1.582 mm Hg to 21.966 ± 2.697 mm Hg, whereas in ropivacaine group it increased from 12.766 ± 1.222 mm Hg to 13.0 ± 1.341 mm Hg after peribulbar anaesthesia.
RESUMEN
PURPOSE: Studying the cognizance and hindrances of eye benefactors amongst relatives of post-mortem cases in an Indian tertiary referral centre. METHODS: This prospective study was executed at a tertiary hospital. In this examination, the relatives had been approached and counselled systematically. The responses had been noted in a predesigned proforma. Data regarding demographic details, socioeconomic status, prior knowledge of eye benefactor, willingness and reasons for refusing eye benefactor, literacy level, relationship with the deceased patient, and so on were collected. RESULTS: One hundred fifty-six potential donors had been identified from 845 post-mortem cases. Among these potential donors were 63 women and 93 men. Thirty-eight next of kin had been seen as already cognizant regarding eye benefactor; however, other 118 families were unaware. A total of 109 families refused to donate eyes while other 47 showed willingness for the procedure. It was seen that there was no influence on literacy status, socioeconomic status and prior knowledge regarding the concept of willingness to donate. CONCLUSION: Counselling for eye benefactor exercises a crucial role in procuring corneas. Socioeconomic status, literacy and prior understanding of eye donation had no link with donor corneal tissue procurement in our study. Even in families with no prior knowledge and poor socioeconomic status, active counselling can be successful.