Sodium bicarbonate versus hyaloronidase in peribulbar anaesthesia

Abstract

The goals of safe, effective anaesthesia is to achieve good surface anaesthesia, akinesia, hypotony, analgesia. Peribulbar anesthesia is a safer to minimize complications of retrobulbar anesthesia. Hyaluronidase is used to aid in the better diffusion of anaesthetic solution. The cost, limited shelf life, risk of anaphlylaxsis are its limiting factors. Hence the need for studying the efficacy of sodium bicarbonate as an alternative to hyaluronidase. Materials and Methods: Prospective randomized study on 100 patients who underwent cataract surgery. Group A was injected with an anaesthetic mixture containing 0.5% bupivacaine, lignocaine with adrenaline with 1ml hyaluronidase. Group B was injected with an anaesthetic mixture of 0.5% bupivacaine and lignocaine 2% to which 7.5% sodium bicarbonate was added. Results: Group A onset of anaesthesia 5 minutes 46(92%), 50(100%) of group B five minutes. Akinetic action of agent 1 better than agent 2., chemosis 16 (32%) in group A,18 (34%) group B. Lid edema nil group A, 17 (34%) of group B. Subconjunctival hemorrhage 3(6%) group A, 4(8%) group B. Peribulbar hemorrhage nil group A, 2(4%) group B. Globe perforation none. Raised IOP 1(2%) group A, 12(24%) group B Overall effective anaesthesia, akinesia achieved in 49 patients (98%) of group A, 43 (86%) of group B. Systemic complication in 1(2%) of group B. Conclusion: The present study showed that sodium bicarbonate is a effective alternative to hyaluronidase in peribulbar anaesthesia. Keywords: Cataract surgery, Hyaluronidase, Peribulbar anaesthesia, Sodium bicarbonate.