Dexmedetomidine in Topical Versus Peribulbar Anesthesia for Cataract Surgery
Dexmedetomidine as an Additive to Topical Versus Peribulbar Anesthesia for Cataract Surgery
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Ocular surgery may be performed under topical, regional, or general anesthesia. The first recorded use of regional anesthesia for surgery was the instillation of cocaine into the conjunctival sac in 1884 by an Austrian ophthalmologist.
Davis and Mandel in 1986 described the peribulbar block, peribulbar block has delayed onset and need a higher volume of local anesthetic (LA) than a retrobulbar block. But the peribulbar block is away from intra-conal space and so produce fewer complication.
Dexmedetomidine is used as adjuvant to LA drugs in peripheral nerve block, brachial plexus block and intrathecal anesthesia with satisfactory results. A more recent study using dexmedetomidine (50 μg) with the peribulbar block before cataract surgery demonstrated an IOP decrease similar to IV dexmedetomidine administration and greater than a peribulbar block without dexmedetomidine.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Mohammed F Algyar, MD
- Phone Number: 047 00201111645345
- Email: mohammad.algaiar@med.kfs.edu.eg
Study Locations
-
-
Kafrelsheikh
-
Kafr Ash Shaykh, Kafrelsheikh, Egypt, 33516
- Recruiting
- Mohammed Fouad Mohamed Algyar
-
Contact:
- Mohammed F Algyar, MD
- Phone Number: 047 00201111645345
- Email: mohammad.algaiar@med.kfs.edu.eg
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- American Society of Anesthesiologists (ASA) physical status classification I or II who scheduled for eye surgery
Exclusion Criteria:
- Patients who are younger than 18 years
- The usual contraindications for regional anesthesia such as patients refusing LA
- Clotting abnormalities
- Impaired mental status
- Allergy to any of the study medications
- patients had the severe cardiac disease
- chronic obstructive lung disease and a history of sleep apnea
- contraindications to the use of dexmedetomidine
- history or significant cardiovascular disease risk factors
- significant coronary artery disease or any known genetic predisposition
- history of any kind of drug allergy
- drug abuse
- psychological or other emotional problems
- special diet or lifestyle
- clinically significant abnormal findings in physical examination
- electrocardiographic (ECG) or laboratory screening
- known systemic disease requiring the use of anticoagulants.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Topical dexmedetomidine group
Patients will receive mixture of one milliliter of dexmedetomidine-HCl and local anesthetic
|
Patients will receive mixture of one milliliter of dexmedetomidine-HCl and local anesthetic
|
|
Active Comparator: Reginal dexmedetomidine group
Patients will receive mixture of bupivacaine 0.5% (4.5 ml) + lidocaine 2% (4.5 ml) + dexmedetomidine 50 μg (1 ml) in peribulbar block
|
Patients will receive mixture of bupivacaine 0.5% (4.5 ml) + lidocaine 2% (4.5 ml) + dexmedetomidine 50 μg (1 ml) in peribulbar block
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Inadvertent eye movement
Time Frame: 2 hours postoperatively
|
Asses intra-ocular pressure (IOP) before injection of baseline and after a complete akinesia of the globe before surgical incision.
|
2 hours postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Anesthesia-related complications
Time Frame: 2 hours postoperatively
|
The patients will be asked whether the cataract surgery was more or less painful than having the needle used for intravenous infusions inserted into the back of the hand.
|
2 hours postoperatively
|
|
Sedation level
Time Frame: 2 hours postoperatively
|
Numeric Rating Scale will be applied to grade the pain where 0 = no pain and 10 = extreme pain.
|
2 hours postoperatively
|
|
pain during and after the surgery
Time Frame: 2 hours postoperatively
|
Immediately after surgery, patients will be asked to grade the pain felt during the operation, including the pain felt after delivery of topical or peribulbar anaesthesia.
|
2 hours postoperatively
|
|
Need for additional anesthesia during surgery and surgeon
Time Frame: During surgery
|
The dose of additional needed anesthesia (fentanyl 0.5 µg/kg) during surgery will be recorded
|
During surgery
|
|
Intraoperative difficulties
Time Frame: 2 hours postoperatively
|
The surgeon will also be requested to grade any difficulties encountered during surgery immediately after the operation, using a 4-point scale, where 1 = no difficulty and 4 = extremely difficult
|
2 hours postoperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Mohammed F Algyar, MD, Lecturer of Anaesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Kafrelsheikh University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
- Eye Diseases
- Lens Diseases
- Cataract
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Non-Narcotic
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Hypnotics and Sedatives
- Dexmedetomidine
Other Study ID Numbers
Other Study ID Numbers
- MKSU 50-11-3
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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