Combined general anesthesia and peribulbar block with ropivacaine and colonidine in patients undergoing retinal detachment surgery

The aim of this study was to evaluate the effects of peribulbar injection of 1% ropivacaine and hyaluronidase with 0.5 microg/kg clonidine combined with GA on the occurrence of oculocardiac reflex, IOP, surgical bleeding, postoperative pain, and occurrence of postoperative nausea and vomiting [PONV]. We enrolled 60 patients scheduled for primary retinal detachment surgery. They randomly allocated to one of two groups to receive either GA plus PB block by 1% ropivacaine and hyaluronidase 16 lU/mL with clonidine in a dose of 0.5 micro g/kg [PB group, n= 30] or GA alone [control group, n = 30]. In the PB group, the incidence of oculocardiac reflex was decreased; intraocular pressure and surgical bleeding were reduced. Immediate postoperative pain scores were lower, and the time of administration of the first postoperative analgesic was longer. Both the number of patients who required an analgesic supplement and the total amount of additional analgesic requested were smaller in the PB group. The two groups were similar with respect to the incidence of postoperative nausea and vomiting. PB block combined with GA was superior to GA alone for retinal detachment surgery with scleral buckling, resulting in less intraoperative bleeding and less incidence of intraoperative occurrence of oculocardiac reflex and also improving postoperative analgesia

Central corneal thickness [CCT] as an additional parameter to monitor childhood glaucomas after glaucoma surgery

The purpose of this study was to investigate the role of CCT as an additional parameter to monitor childhood glaucomas after glaucoma surgery. This study included postoperative 18 eyes of 10 children [8 with bilateral glaucoma and 2 with unilateral glaucoma], All children were operated with one surgeon and with one technique which was combined trabeculotomy-trabeculectomy [CTT] with mitomycin C [MMC] 0.3 mg/ml. IOP and CCT were evaluated 1-3 weeks post-operatively. Overestimation of IOP was found in 13 out of 18 eyes [72,2%] included in the study, 2 eyes with aniridia, 2 eyes with aphakia and 9 eyes with residual clouding of the cornea post-operatively. Underestimation was found in 3 out of 18 eyes [16.7%] of the study all of them had clear cornea post-operatively while no changes of IOP according to corneal thickness was found in 2 out of 18 eyes [11.1%]. From the results of this study we can conclude that central corneal thickness measurement should be considered as an additional parameter when evaluating IOP in congenital glaucoma