Sub-tenon's block in cataract surgery a comparison of 2% articaine and a mixture of 2% lignocaine and 0.5% bupivacaine

Articaine is a novel amide local anaesthetic with a shorter duration of action than prilocaine. Sub-Tenon's anaesthesia arguably provides a safer method of anesthetic delivery for cataract surgery. In our study we compared 2% articaine with mixture of 2% lignocaine and 0.5% bupivacaine through sub-Tenon's block for cataract surgery. 60 ASA [American Society of Anesthesiologists] I-III patients were selected for comparison and allocated in two equal groups in randomized double-blinded study. We found that sub-Tenon's block using articaine 2% resulted in a more rapid onset of motor block than lidocaine / bupivacaine mixture [mean time to readiness for surgery was 3.3 +/- 2.4 [SD] min. in articaine group vs. 5.1 +/- 3.2 [SD] min. in lidocaine/bupivacaine group [p=0.0077]. Ocular movement scores were significantly lower from 2 min. after injection until the end of surgery p = 0.021 [p

Intraocular pressure during lumbar disc surgery - a comparative study between prone position and knee-elbow position

Post-operative visual loss occurs more commonly in spinal surgery. Increased intra-ocular pressure is often Implicated In the etiology of postoperative visual impairment. We Investigated intraocular pressure in 20 patients undergoing lumber disc surgery. We classified the patients into two groups: Group I: patients were in the knee-elbow position with the head resting on a cushion and turned to one side and group II: patients were in prone position and the head neutral. We classified patients in knee-elbow position into two sub-groups: subgroup A where we measured IOP in nondependant eye and subgroup B where we measured IOP in dependant eye. In both groups we measured lOP during 2 times, the first time in both group when the patients were awake and In supine position and the second time was In group I at the end of surgery when the patients were still anesthetized and in knee elbow position and in group II at the end of surgery when the patients were still anesthetized and in prone position. In group I after mean duration of surgery 120 +/- 18 min. [mean +/- SD], the mean intra-ocular pressure in the non-dependnnt eye was unchanged when compared to awake state 16.3 +/- 2.1 vs. 17.2 +/- 3.2 mmHg [p >/= 0.05]. whereas the intraocular pressure in the dependant eye had significantly increased 17.1 +/- 2.2 vs. 19.2 +/- 1.1 mmHg [p<0.05]. In group II after mean duration of surgery 119 +19 mmHg, mean Intra-ocular pressure had highly significant increase compared to awake state 16.7 +/- 2.2 vs. 21.3 +/- 2.1 mmHg [p<0.01]. We conclude that IOP increased when anesthetized - patients are placed in prone position more than when placed in knee-elbow position