Nehra Poonam, Oza Vrinda, Parmar Vandana, Fumakiya Pooja
Department of Anesthesiology, P. D. U. Medical College, Rajkot, Gujarat, India.
J Pharmacol Pharmacother. 2017 Jan-Mar;8(1):3-7. doi: 10.4103/jpp.JPP_109_16.
To compare the effect of addition of fentanyl and clonidine as adjuvants to bupivacaine and lignocaine in peribulbar block.
The study was conducted on 105 adult patients of either sex, of ASA grade I and II undergoing ophthalmic surgeries. Patients were randomly divided into 3 groups of 35 each. All the patients were given peribulbuar block with 5ml lignocaine 2% +3 ml bupivacaine 0.5% +1 ml hyaluronidase (250 IU). In addition to this 1 ml normal saline was added to Group S, 25 μg fentanyl to Group F and 25 μg clonidine to Group C. Onset and duration of globe and lid akinesia, duration of sensory blockage and analgesia, hemodynamic parameters, number of rescue analgesic and visual analogue score were recorded.
The mean time of onset of globe and lid akinesia was significantly faster in group F and group C compared to group S, mean duration of globe and lid akinesia was longer in Group F (207.71 + 13.54 and 143.14 + 7.86 min) and group C (213.52 + 14.52 and 162.06 + 17.1 min) compared to group S (117.78 + 10.42 and 87.64 + 9.76 min). The mean duration of analgesia was significantly longer in group F (217.71 + 12.67) and C (258.82 + 14.50 min) as compared to group S (131.39 + 9.63 min).
Addition of fentanyl or clonidine as adjuvant to local anaesthetic in peribulbar block provides faster onset and prolonged analgesia compared to local anaesthetic alone.
比较在球周阻滞中添加芬太尼和可乐定作为布比卡因和利多卡因佐剂的效果。
对105例接受眼科手术的ASA I级和II级成年患者（男女不限）进行研究。患者被随机分为3组，每组35例。所有患者均接受5ml 2%利多卡因+3ml 0.5%布比卡因+1ml透明质酸酶（250IU）的球周阻滞。除此之外，S组添加1ml生理盐水，F组添加25μg芬太尼，C组添加25μg可乐定。记录眼球和眼睑运动不能的起效时间和持续时间、感觉阻滞和镇痛的持续时间、血流动力学参数、补救性镇痛药的数量和视觉模拟评分。
与S组相比，F组和C组眼球和眼睑运动不能的平均起效时间明显更快，F组（207.71 + 13.54和143.14 + 7.86分钟）和C组（213.52 + 14.52和162.06 + 17.1分钟）眼球和眼睑运动不能的平均持续时间比S组（117.78 + 10.42和87.64 + 9.76分钟）更长。与S组（131.39 + 9.63分钟）相比，F组（217.71 + 12.67）和C组（258.82 + 14.50分钟）的平均镇痛持续时间明显更长。
在球周阻滞中，与单独使用局部麻醉药相比，添加芬太尼或可乐定作为局部麻醉药的佐剂可提供更快的起效时间和更长时间的镇痛效果。
