A Comparison of One-site and Two-site Peribulbar Anaesthesia for Cataract Surgery at Kaduna, Nigeria
A Comparison of One-site and Two-site Peribulbar Anaesthesia for Cataract Surgery at National Eye Centre, Kaduna. Nigeria
The aim of the study was to compare the efficacy and safety of single injection peribulbar anaesthesia against the classic double injection technique.
This was a double blind randomized controlled trial involving two groups of consenting, adult Nigerian subjects with operable age-related cataract. An anaesthetic nurse who allocated the subjects to the two groups administered all the injections. The same surgeon operated on all the subjects while the principal investigator and a research assistant measured the outcome variables. All others were blinded as to subject allocation.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Kaduna, Nigeria, 800001
- National Eye Centre
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 50 years and above
- Diagnosed with uncomplicated senile cataract
- Visual acuity of <3/60
Exclusion Criteria:
- Impaired mental status
- Difficulty in speaking
- Known allergy to amide-type local anaesthetic agents and/ or hyaluronidase
- Previous surgery in the same eye
- Glaucoma
- Impaired ocular motility
- Eyelid abnormalities
- Patients with only one eye
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: One-site peribulbar injection
Injection of a mixture of lidocaine 2% + adrenaline 0.125mg/ml + hyaluronidase 15 International Units (IU)/ml into the inferior medial orbital compartment
|
injection into the inferior medial orbital compartment
|
|
ACTIVE_COMPARATOR: Two-site peribulbar injection
Injection of a mixture of lidocaine 2% + adrenaline 0.125mg/ml + hyaluronidase 15IU/ml into the infero-temporal and supero-nasal orbital compartments
|
Two injections into the infero-temporal and supero-nasal orbital compartments
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time Taken to Achieve Adequate Akinesia
Time Frame: 10 minutes and 15 minutes
|
Time taken to achieve akinesia and anesthesia adequate for surgery.
Ability to move the eye in each of four directions (up, down, right and left) was scored thus: 2- normal movement, 1- reduced movement and 0- flicker or no movement.
Upper eyelid akinesia was scored as 2- normal opening, 1- reduced movement and 0- complete immobility.
Maximum score of 10 and minimum of 0. Adequate akinesia was defined as a total score of <4 and was evaluated at 10 and 15 minutes.
|
10 minutes and 15 minutes
|
|
Supplementary Injection(s)
Time Frame: 5 minutes
|
After 10 minutes if akinesia score was more than 3, supplementary injections were given and the effect assessed was 5 minutes later
|
5 minutes
|
|
Complications of Local Anaesthetic Injection
Time Frame: 0,10 and 15 minutes
|
Systemic complications: dyspnoea, bronchospasm, impaired consciousness, intravascular injection etc Local complications: eyelid oedema, corneal oedema, conjunctival chemosis, conjunctival haemorrhage, globe perforation, vitreous haemorrhage, orbital haemorrhage etc |
0,10 and 15 minutes
|
|
Pain Score for Local Anaesthetic Injection
Time Frame: 20 minutes
|
Pain was scored using a 4 point scale: 1 - no pain, 2 - mild pain, 3 - moderate pain, 4 - severe pain
|
20 minutes
|
|
Pain Score for Cataract Surgery
Time Frame: 20 minutes
|
Pain was scored on a 4 point scale: 1 - no pain, 2 - mild pain, 3 - moderate pain, 4 - severe pain
|
20 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Volume of Anaesthetic Drug (ml)
Time Frame: 10 and 15 minutes
|
Total volume of anaesthetic drug injected into the orbit to achieve anaesthesia and akinesia adequate for cataract surgery
|
10 and 15 minutes
|
|
Total Number of Injections
Time Frame: 15 minutes
|
Total number of injections required to achieve an akinesia score of <4
|
15 minutes
|
|
Surgeon Satisfaction Score for Local Anaesthetic Block
Time Frame: 20 minutes
|
Surgeon subjectively scored satisfaction with the anaesthetic block on a 4 point scale: 1- poor (25%), 2 - fair (50%), 3 - good (75%), 4 - excellent (100%)
|
20 minutes
|
|
Acceptability of the Anaesthetic Block to the Subject
Time Frame: 25 minutes
|
Subjects were asked if they would agree to have the same anaesthetic procedure the next time they needed cataract surgery in the other eye
|
25 minutes
|
|
Duration of Cataract Surgery (Minutes)
Time Frame: At the end of surgery
|
Time interval from conjunctival incision to application of eye pad
|
At the end of surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Aminatu A AbdulRahman, MBBS, FWACS, National Eye Centre, Kaduna
- Study Chair: Mahmoud B Alhassan, MBBS, FWACS, National Eye Centre, Kaduna
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- NECKAD/TRIALS/001/2012
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