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Register a new userTopical Anesthesia in Phacoemulsification with IOL Implantation
التخدير الموضعي بالتقطير في جراحة استخراج الساد باستحلاب العدسة مع غرس عدسة داخل العين
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Damascus University ورقة بحثية
Publication date
2005
fields
Medicine
and research's language is
العربية
Authors
أحمد باسم بريدي( باحث )
Created by
Shamra Editor
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هدف البحث إلى دراسة فعالية التخدير الموضعي بالتقطير في جراحة استخراج الساد باستحلاب العدسة مع غرس عدسة داخل العين. جري البحث في الشعبة العينية ـ قسم أمراض الرأس ـ جامعة دمشق بين عام 1998 و عام 1999 ،على 56 عيناً لـ 48 مريضاً بينهم 26 رجلاً و 22 امرأة، و كان متوسط أعمارهم 52 ± 26 سنة.
Purpose: to assess the efficiency of topical anesthesia in phacoemulsification with IOL implantation. Department of Ophthalmology, Muasaa Hospital. The research was carried on 56 eyes of 48 patients.
Artificial intelligence review:
Research summary
تتناول هذه الدراسة فعالية التخدير الموضعي في عمليات استحلاب العدسة مع زراعة العدسة داخل العين. أجريت الدراسة في قسم طب العيون بمستشفى موسى على 56 عينًا من 48 مريضًا. تم تقسيم الحالات إلى مجموعتين: الأولى خضعت للجراحة تحت التخدير الموضعي بدون أي أدوية مهدئة، بينما خضعت المجموعة الثانية للتخدير الموضعي مع استخدام الميدازولام والفنتانيل في بعض الأحيان. استخدم الباحثون بنوكساين هيدروكلوريد 0.4% وطلبوا من المرضى تقييم الألم والانزعاج الذي شعروا به خلال الجراحة. أظهرت النتائج أن معظم المرضى لم يشعروا بأي ألم، بينما شعر البعض الآخر بألم طفيف. خلصت الدراسة إلى أن التخدير الموضعي في هذه العمليات فعال وآمن ويوفر إعادة تأهيل بصري سريعة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة مهمة في تقييم فعالية التخدير الموضعي في عمليات استحلاب العدسة، إلا أن هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة قد يكون غير كافٍ لتعميم النتائج على نطاق أوسع. ثانياً، لم يتم تناول تأثير التخدير الموضعي على المرضى الذين يعانون من حالات طبية معقدة أو حساسية للأدوية المستخدمة. ثالثاً، كان من الأفضل تضمين مجموعة ضابطة خضعت لتخدير مختلف لمقارنة النتائج بشكل أكثر دقة. على الرغم من هذه النقاط، فإن الدراسة تقدم معلومات قيمة يمكن أن تكون مفيدة في تحسين ممارسات الجراحة العينية.
Questions related to the research
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ما هو الهدف الرئيسي من الدراسة؟
الهدف الرئيسي هو تقييم فعالية التخدير الموضعي في عمليات استحلاب العدسة مع زراعة العدسة داخل العين.
-
كم عدد المرضى الذين شاركوا في الدراسة؟
شارك في الدراسة 48 مريضًا، وتم إجراء الجراحة على 56 عينًا.
-
ما هي الأدوية المستخدمة في التخدير الموضعي؟
تم استخدام بنوكساين هيدروكلوريد 0.4%، وفي بعض الحالات تم استخدام الميدازولام والفنتانيل.
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ما هي النتائج الرئيسية للدراسة؟
أظهرت النتائج أن معظم المرضى لم يشعروا بأي ألم خلال الجراحة، وأن التخدير الموضعي كان فعالًا وآمنًا ويوفر إعادة تأهيل بصري سريعة.
References used
Duker Js. Belmont JB. Benson WE. et al. Inadvertent globe perforation during retrobulbar and peribulbar anesthesia. Patient characteristics, surgical management, and visual outcome. Ophthalmology 1991;98:519-26
Sullivan KL. Brown GC, Forman AR, et al. Retrobulbar anesthesia and retinal vascular obstruction. Ophthalmology 1983;90:373-7
Feivel RM. Current concepts in retrobulbar anesthesia. Surv Ophthalmol 1985;30:102-10
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The purpose of this paper is to determine whether there is a difference in the postoperative corneal astigmatism and uncorrected visual acuity UCVA as well as best corrected visual acuity BCVA between 2 types of clear corneal incisions used in phacoe
mulsification: the superior and on the steepest clear corneal incision.
This study included 40 patients with cataract and mild to moderate corneal astigmatism (0.50 D - 2.00 D) who underwent phacoemulsification with foldable posterior chamber lens (with 3.2mm corneal incision). Patients were randomly divided into two groups: superior clear corneal incision group SCCI (20 eyes) and on the steepest clear corneal incision group OCCI (20 eyes). Measurements included corneal astigmatism by Keratometry, UCVA and BCVA. These Measurements were taken on first day,1 week, 2 weeks,1, 2,3 and 6 months. The mean preoperative corneal astigmatism was (1.24 D ± 0.44),(1.25 D ± 0.44) in superior corneal incision group, and on the steepest corneal incision group, respectively. After 6 months postoperatively, the mean corneal astigmatism was (1.53 D ± 0.49) in SCCI group, (1.03 D± 0.39) in OCCI group, with statistically significant difference (p<0.001).There was statistically significant difference in UCVA. But there was no statistically significant difference in BCVA.
The paper concludes that compared with SCCI, the OCCI could correct some corneal astigmatism
Protection against cardiac ischemia/reperfusion injury is the basic objective in open heart surgery, and it may be achieved by pharmacological preconditioning or Postconditioning. In this study, we aimed to compare the effects of two different anest
hetic techniques (inhalation and total intravenous anesthesia) on ischemia-reperfusion injury in Coronary Artery Bypass Graft surgery. 80 CABG patients were randomly assigned into one of tow groups: Group A Sevoflurane (n=40) and Group B total intravenous anesthesia (n=40) with Propofol . data of hemodynamic monitoring and inotrops using were recorded. Arterial blood samples were taken in the preoperative period (T0), 12th hours (T1) ,24th hours (T2) and 48th hours postoperatively, and Troponine I levels were measured . The time of ventilation, ICU and total hospitalization were recorded .
Postoperative levels of troponine I were significantly lower in the Sevoflurane group with less using of inotrops and less staying in the ICU post-op . We conclude that the use of a volatile anesthetic regimen in CABG surgery associate with better preservation of myocardial function and a reduced postoperative release of
troponine I.
Purpose: To evaluate and compare the pharmacological characteristics and clinical efficacy of two topical steroid prednisolone preparations (Redmond®, prednisolone acetate 1%; and Pred Forte®, prednisolone acetate 1%) in reducing postoperative inflam
mation in patients having phacoemulsification surgery with IOL implantation, which will support our trust in national products considering it's availability and lower costs compared with universal products.
Methods:
I- Laboratory Study: Direct microscopic examination of the ophthalmic suspension for both formulations.
II- Clinical Study: This study was interventional, prospective, randomized controlled study included 60 eyes of patients undergoing emulsification surgery with IOL implantation. Patients were assigned to one of two treatment groups, The first group (30 eyes) received Redmond® while the second group (30 eyes) received Pred Forte® in addition to standard therapy. Study drug was administered postoperatively every 2 hours while awake for 7 days, then four times daily for 7 days, then twice daily for 7 days, then once daily for 7 days. Clinical efficacy was compared for differences in visual acuity, anterior chamber cells (scale 0-4), fundus and macula, drug's ocular adverse effects: foreign body sensation and irritation (scale 1-3), and intraocular pressure (IOP). Results were compared on day 1, day 3, 1 week, 2 weeks, and 1 month postoperatively.
Results:
I- Average particle size in ophthalmic suspension for both formulations was (< 1 μm). (Redmond® = 0.95 μm, Pred Forte® = 0.77 μm).
II- No statistical differences in clinical efficacy or safety were seen between the two formulations tested at any time point evaluated with respect to visual acuity, anterior chamber cells, fundus and macula, foreign body sensation and irritation, and intraocular pressure (IOP).
Conclusions: In this study of routine cataract patients, both prednisolone acetate 1% formulations are comparably effective and safe when administered for the reduction of inflammation after phacoemulsification surgery with IOL implantation. Direct microscopic examination showed that both formulations achieved the condition that particle size in ophthalmic suspension must be less than one micron.
Cataract
Phacoemulsification
ساد
جراحة استحلاب العدسة
الارتكاس الالتهابي ما بعد الجراحة
الاستجابة الالتهابية
تحطم الحاجز الدموي الخلطي
مستحضر بريدنيزولون أسيتات 1%
معلّق عيني
حجم الجسيم الدوائي
postoperative inflammation
inflammatory response
blood-aqueous barrier breakdown
prednisolone acetate 1% formulation
ophthalmic suspension
particle size
المزيد..
This study was carried out in the department of anesthesia and reanimation at
Alassad ,Tishreen university Hospitals , Lattakia , Syria , during the year 2014-2015 , and
included 45 patients of either sex (5-15 kilogram of weight ) undergoing lower
abdominal
and urologic procedures.
Patients were divided into three groups :
Patients of group A : received spinal anesthesia by using combination between
bupivacaine (0.4 mg/kg ) and normasaline (placebo) .
Patients of group B : received spinal anesthesia by using combination between
bupivacaine (0.4 mg/kg ) and fentanyl (0.2 mcg/kg ) .
Patients of group c : received spinal anesthesia by using combination between
bupivacaine (0.4 mg/kg ) and fentanyl (0.6 mcg/kg ) .
The goal of the study is studying the effects of combination between fentanyl and
bupivacaine in the spinal anesthesia for the children whom prepared to subumblical
operations .
Conclusion :
Combination between fentanyl and bupivacaine reduced to use postoperative
narcotics and increased the duration of spinal anesthesia, in addition to provided
hemodynamic stability during the operation.
The injection of needle is an action of fear and pain, especially for young children , so it is important that we resort to a method of pain-free when applying the local anesthesia.
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