The Use of Pterugoplatine Blockade with Dexamethasone for Anesthetization in Enucleation and Evisceration

Abstract

Introduction. Traditionally the well proven retrobulbar anesthesia as an independent method of pain relief is used in ophthalmology, but there are also disadvantages of this type of anesthesia. Objectives. To develop and evaluate the clinical efficacy of the combined method of pain relief during evisceration or enucleation of the eyeball, including the blockade of the pterygopalatine ganglion by local anesthetic and dexamethasone as an adjuvant, and inhalation anesthesia with sevorane. Material and Methods. A comparative analysis of the effectiveness of intraoperative anesthesia and course of postoperative period in patients of two clinical groups, which were formed according to the method of anesthesia, were held. Results. The nature of pain sensation in patients of comparable groups had significant differences; except the presence and intensity of pain, the degree of edema and conjunctival injection were assessed. Conclusions. The use of pterygopalatine blockade with lidocaine and naropin in combination with dexamethasone as adjuvant provides a prolonged analgesic, anti-inflammatory and anti-edematous effect. This makes it possible to avoid the use of opioid analgesics in early postoperative period, i. e. to avoid systemic side effects such as nausea, dizziness, vomiting, in rare cases, which generally improves the quality of the postoperative period. Application of the pterygopalatine ganglion blockade with mixture of local anesthetics with different durations of action and dexamethasone as an adjuvant based on inhalation anesthesia with sevorane provides safe and effective analgesia in patients during evisceration or enucleation of eyeball, both intra- and postoperatively.