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Retinal surgeryOnly 14 pages are availabe for public view
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Abstract
Different anesthetic adjuvants can be used as supplements to general anesthesia to attenuate various stress responses during surgery providing peri-operative hemodynamic stability, and to reduce peri-operative anesthetic requirements, postoperative pain, analgesic consumption, the length of hospital stay with improvement of postoperative quality of recovery. Objective : To compare the effects of co-administration of dexmedetomidine, magnesium sulfate, or lidocaine as supplements to general anesthesia on peri-operative hemodynamic stability and post-operative recovery in patients undergoing retinal surgery. Patients and methods : Eligible 160 patients were randomly allocated into four groups : group D received dexmedetomidine, group M received magnesium sulfate, and group L received lidocaine, while patients in group C received the same volume as normal saline. The hemodynamic changes, blood glucose levels, intra-ocular pressure as well as post-operative pain scores, analgesic requirements, nausea and vomiting were recorded in each group.
Results: Dexmedetomidine, magnesium sulfate, and lidocaine have decreased stress response to anesthesia and surgery as signified by decreased HR and MAP in comparison to control group. Also, amelioration of the stress response could be represented by significant lower blood glucose levels in dexmedetomidine group as compared to control group at one hour after recovery, and in the three studied groups relative to control group after six hours. In addition, a significant DROP in IOP measurements was occurred in the three studied groups as compared to control group. The three studied groups have showed significant reduction in pain scores of the 1st post-operative four hours and the total pethidine consumption with lower incidence of PONV, in comparison to control group. Conclusion: Peri-operative infusions of dexmedetomidine, magnesium sulfate or lidocaine as anesthetic adjuvants for general anesthesia during retinal surgery can be considered as effective modalities in ameliorating the pressor responses to many anesthetic and surgical manipulations. As well, dexmedetomidine has been superior to other regimens as regards to peri-operative stable hemodynamics, blood glucose levels and intra-ocular pressure, while lidocaine can provide an acceptable post-operative recovery profile and opioid sparing analgesic effects.