Effect of fentanyl addition to local anesthetic mixture in peribulbar block for cataract surgery

Abstract

Background In peribulbar regional anesthetic blocks, injection of local anesthetic mixtures alone provide unsatisfactory surgical conditions as regards block intensity and duration especially for relatively lengthy operations. So, additives may improve the quality of the block and provide good postoperative analgesia. Aim To examine the effect of adding fentanyl to local anesthetics in peribulbar block on the onset and duration of lid and globe akinesia (primary outcome) and postoperative analgesia (secondary outcome). Patients and methods Patients were classified randomly allocated in a blind manner into two groups; each group contained 30 patients. The control group received a measure of 7 ml [3 ml lidocaine 2%+0.5 ml hyaluronidase (150 U)+2.5 ml bupivacaine 0.5%+1 ml saline] which was used locally and the fentanyl group received a measure of 7 ml [3 ml lidocine2%+0.5 ml hyaluronidase (150 U)+2.5 ml bupivacaine 0.5%+1 ml saline containing 20 μg fentanyl] which was used locally. Results Statistically significant decreased mean time of complete akinesia decreases the mean time to sensory block in the fentanyl group compared with the control group. Conclusion Fentanyl is an effective drug as an additive to local anesthetic mixture in peribulbar anesthesia, as it shortens the onset time of corneal anesthesia and globe akinesia, prolongs block duration, and good postoperative analgesia.