Continuous peri-bulbar anesthesia in vitreo retinal surgery

Assessment of the use of a peri-bulbar IV cannula to introduce intra operative local anesthesia in prolonged vitreo retinal surgical procedures using different anesthetic combinations. Twenty eight eyes of 28 patients requiring vitreo retinal surgery in the form of: scleral buckling, pars plana vitrectomy or both were operated on with local anesthesia with a fixed peri-bulbar plastic IV cannula. The patients were divided in three groups: Group 1 in whom a small and slow initial injection of Mepicaine with epinephrine and Pubivacaine was used, group 2 in whom rapid injection of 10 ml of lidocaine and pubivacaine was used and group 3 in whom a 10 ml rapid injection of the lidocaine, mepicaine with epinephrine and pubivacaine was used Patients of group 1 showed a more prolonged anesthetic effect followed by those of group 3. The least effective with a rapid fading of the anesthetic effect was the patients of group 2. A temporary peri-bulbar cannula is an effective way to supplement local anesthesia in lengthy vitreoretinal surgery especially if the initial injection was given slowly in a small volume using a combination of mepicaine and pubivacaine

Peribulbar anesthesia with Ropivacaine in strabismus surgery

To study the efficacy of ropivacaine in peribulbar injection for strabismus surgery and to evaluate its selectivity between sensory and motor blockade. Sixty patients ranging in age from 16-70 years underwent strabismus surgery under local anesthesia. Patients were given ropivacaine 0.2 percent [2 mg/ml] with hyaluorinidase 10 Iu/ml in peribulbar injection. Ocular motility was checked during surgery. During surgery all patients never expressed any pain but the ocular motility was limited. Ropivacaine is effective in peribulbar injection for strabismus surgery. Benefit of this technique, avoidance of certain hazards of general anesthesia and intraoperative muscle adjustment of selected cases of squint with large angle

Carotid duplex sonography in transient ischemic attack

Duplex sonography, combining B-mode imaging and doppler spectrum analysis, has been proved to be an accurate and effective means of detecting and assessing carotid occlusive disease. High resolution imaging allows assessment of the risk of embolism through plaque characterization, while image and doppler spectrum analysis provide quantification of flow characteristics to determine the degree of stenotic flow restriction