The Experts below are selected from a list of 297 Experts worldwide ranked by ideXlab platform
Seung Hye Jung - One of the best experts on this subject based on the ideXlab platform.
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shivering after Retrobulbar Block during cataract surgery a case report
Korean Journal of Anesthesiology, 2008Co-Authors: Seung Hye JungAbstract:Retrobulbar Block is commonly performed under monitored anesthesia prior to cataract surgery. Known complications associated with Retrobulbar Block include cranial nerve palsies, seizures, and cardiorespiratory arrest. We report a case of severe shivering following a Retrobulbar Block. Two minutes after the Block was administered, the patient experienced severe shivering, which subsided after injection of pethidine 25 mg. The likely etiology of the shivering was inadvertent dural puncture of the optic nerve sheath and local anesthetic spread into the cerebrospinal fluid space. Shivering may be a warning sign of brain stem anesthesia, and in such a scenario the clinician should direct special attention to possible life-threatening complications. (Korean J Anesthesiol 2008; 55: 226～8)
Soudabeh Haddadi - One of the best experts on this subject based on the ideXlab platform.
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efficacy of preoperative administration of acetaminophen and melatonin on Retrobulbar Block associated pain in cataract surgery
Anesthesiology and Pain Medicine, 2018Co-Authors: Soudabeh Haddadi, Reyhaneh Shahrokhirad, Malek Moien Ansar, Shideh Marzban, Mitra Akbari, Arman ParviziAbstract:Background: Retrobulbar Block is one of the chosen methods for local anesthesia in cataract surgery. Since it is a painful procedure, using analgesic and sedative drugs is recommended. Current medications have side effects and evaluating of new drugs or new uses of existing safer drugs is necessary. Objectives: The aim of this study was to compare the administration of melatonin and acetaminophen on pain and hemodynamic changes during Retrobulbar Block. Methods: In a double-blinded randomized trial, 180 patients undergoing cataract surgery were randomly divided into three groups: Melatonin group (received melatonin 6 mg), acetaminophen group (received acetaminophen 500 mg), and control group (received placebo). All drugs were administered orally 60 min before arrival to the operating room by nurses blinded to the drugs administered. All patients received fentanyl 0.5 μg/kg before Retrobulbar Block intravenously. Hemodynamic variables and pain score in each patient were evaluated on arrival in the operating room, during Retrobulbar Block, during surgery, 20 min after operation, at the end of surgery, and in the recovery room. In case of pain score more than three, additional fentanyl was administered. All data were recorded in structured data sheets. Results: Data analysis indicated no significant differences among the groups at baseline on any of the demographic variables. Both acetaminophen and melatonin reduced the pain score significantly compared with control during Retrobulbar Block (P < 0.05 and P < 0.01, respectively). Administration of additional fentanyl was significantly lower in the melatonin group than the control group (P < 0.05). Hemodynamic changes were not significantly different among all groups. Conclusions: For the first time, as far as we have studied, the analgesic effect of acetaminophen on the Retrobulbar Block was indicated. We also showed that melatonin can reduce pain during Retrobulbar Block leading to reduction of additional fentanyl during operation. It seems that both melatonin and acetaminophen may have a beneficial effect on pain control in the Retrobulbar Block.
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comparing the effect of topical anesthesia and Retrobulbar Block with intravenous sedation on hemodynamic changes and satisfaction in patients undergoing cataract surgery phaco method
Anesthesiology and Pain Medicine, 2015Co-Authors: Soudabeh Haddadi, Shideh Marzban, Arman Parvizi, Baharak Fazeli, Abtin Heidarzadeh, Bahram Naderinabi, Mohamad Reza Panjtan PanahAbstract:BACKGROUND: Cataract is one of the most common surgical procedures in the elderly. In most cases, the elderly have cardiac ischemia or chronic coronary diseases, which would lead to more ischemic events during general anesthesia. Therefore, surgeons and anesthetists prefer regional aesthesia to the general one owing to its more advantages and less complications. OBJECTIVES: Therefore, this study aimed to compare topical method and Retrobulbar Block for pain intensity, patient's satisfaction, hemodynamic changes and intra and postoperative complications. PATIENTS AND METHODS: In a single-blinded clinical trial, 114 patients scheduled for cataract surgery, aged 50 to 90 years with ASA physical status of I-III, were randomly assigned to two groups under monitored anesthesia care as topical anesthesia and Retrobulbar Block. After the injection of intravenous sedation, which was the combination of midazolam 0.5-1 mg with fentanyl 0.5-1 µ/kg, patients received retro bulbar Block or topical anesthesia. During the operation, heart rate, systolic and diastolic blood pressure, mean arterial blood pressure and arterial saturation of O2were measured every five minutes. In addition, pain (VAS) and satisfaction (ISAS) scores were recorded every 15 minutes, then at recovery and one hour after the ending of operation in the ward. Findings were statistically analyzed using SPSS 16. RESULTS: In this study, no significant association was found between age, gender, education and physical condition of patients in both topical and retro bulbar Block groups. Comparison of pain based on VAS, satisfaction based on ISAS score and MAP in the studied periods had no significant differences between the two groups of patients undergoing cataract surgery. However, significant differences were found between the two groups (P = 0.045, 0.02, 0.042 and P < 0.05) regarding heart rate, systolic and diastolic blood pressure and arterial oxygen saturation percentage after 20-30 minutes of the operation. CONCLUSIONS: Both methods, topical and retro bulbar Block had similar impression in cataract surgery regarding analgesia and patient satisfaction. However, in non-complicated cataract surgeries with short duration, topical anesthesia may be the preferable method, because of non-invasiveness, appropriate analgesia, patient satisfaction and hemodynamic stability.
Norio Fujiwara - One of the best experts on this subject based on the ideXlab platform.
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A comparison of blood pressure changes in phacoemulsification cataract surgery with topical and Retrobulbar Block local anesthesia
Graefe's Archive for Clinical and Experimental Ophthalmology, 1997Co-Authors: Ryo Suzuki, Shinji Kuroki, Norio FujiwaraAbstract:• Background: Changes are observed in blood pressure (BP) levels during cataract surgery, although BPs are considered to remain stable under local anesthesia. We evaluated the daily, pre- and postoperative BPs of 2270 patients after cataract surgery performed under either topical anesthesia or Retrobulbar Block. • Methods: All operations were performed by the same surgeon using the same method of phacoemulsification and aspiration with posterior chamber intraocular lens implantation under local anesthesia. • Results: The mean daily BP was 99.3±14.2 mm Hg; the mean preoperative BPs increased and then the postoperative BPs decreased. The postoperative BPs of the Retrobulbar injection group decreased significantly more than those of the topical application group. In 833 cases, the systolic BP changed by more than 20 mm Hg. Even when the patients were hypertensive, the preoperative and postoperative BPs decreased in the same manner. • Conclusion: The present study shows that, following surgery with Retrobulbar Block anesthesia, BP decreases to a greater extent than with topical anesthesia. Physicians should be aware of the high proportion of cases in which the systolic BP changes by more than 20 mm Hg.
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a comparison of blood pressure changes in phacoemulsification surgery with topical and Retrobulbar Block local anesthesia part ii
Ophthalmologica, 1997Co-Authors: Ryo Suzuki, Keisuke Kawata, Shinji Kuroki, Norio Fujiwara, Mieko IwamotoAbstract:Although we recently compared blood pressure (BP) changes during cataract surgery between groups that received topical and Retrobulbar Block anesthesia, a study has not been conducted in which patients were matched for age and sex. To draw more meaningful conclusions, we conducted a age- and sex-matched study in which the daily, pre- and postoperative blood pressures of 1,398 cataract patients were compared. All surgeries were performed using the same method of phacoemulsification and aspiration with intraocular lens implantation under local anesthesia. The postoperative BPs of the Retrobulbar injection group decreased significantly more than the topical application group. Even when the patients were hypertensive, the postoperative BPs decreased. Following Retrobulbar Block anesthesia, the BP decreased postoperatively to a greater extent than after topical anesthesia.
Mohamad Reza Panjtan Panah - One of the best experts on this subject based on the ideXlab platform.
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comparing the effect of topical anesthesia and Retrobulbar Block with intravenous sedation on hemodynamic changes and satisfaction in patients undergoing cataract surgery phaco method
Anesthesiology and Pain Medicine, 2015Co-Authors: Soudabeh Haddadi, Shideh Marzban, Arman Parvizi, Baharak Fazeli, Abtin Heidarzadeh, Bahram Naderinabi, Mohamad Reza Panjtan PanahAbstract:BACKGROUND: Cataract is one of the most common surgical procedures in the elderly. In most cases, the elderly have cardiac ischemia or chronic coronary diseases, which would lead to more ischemic events during general anesthesia. Therefore, surgeons and anesthetists prefer regional aesthesia to the general one owing to its more advantages and less complications. OBJECTIVES: Therefore, this study aimed to compare topical method and Retrobulbar Block for pain intensity, patient's satisfaction, hemodynamic changes and intra and postoperative complications. PATIENTS AND METHODS: In a single-blinded clinical trial, 114 patients scheduled for cataract surgery, aged 50 to 90 years with ASA physical status of I-III, were randomly assigned to two groups under monitored anesthesia care as topical anesthesia and Retrobulbar Block. After the injection of intravenous sedation, which was the combination of midazolam 0.5-1 mg with fentanyl 0.5-1 µ/kg, patients received retro bulbar Block or topical anesthesia. During the operation, heart rate, systolic and diastolic blood pressure, mean arterial blood pressure and arterial saturation of O2were measured every five minutes. In addition, pain (VAS) and satisfaction (ISAS) scores were recorded every 15 minutes, then at recovery and one hour after the ending of operation in the ward. Findings were statistically analyzed using SPSS 16. RESULTS: In this study, no significant association was found between age, gender, education and physical condition of patients in both topical and retro bulbar Block groups. Comparison of pain based on VAS, satisfaction based on ISAS score and MAP in the studied periods had no significant differences between the two groups of patients undergoing cataract surgery. However, significant differences were found between the two groups (P = 0.045, 0.02, 0.042 and P < 0.05) regarding heart rate, systolic and diastolic blood pressure and arterial oxygen saturation percentage after 20-30 minutes of the operation. CONCLUSIONS: Both methods, topical and retro bulbar Block had similar impression in cataract surgery regarding analgesia and patient satisfaction. However, in non-complicated cataract surgeries with short duration, topical anesthesia may be the preferable method, because of non-invasiveness, appropriate analgesia, patient satisfaction and hemodynamic stability.
Arman Parvizi - One of the best experts on this subject based on the ideXlab platform.
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efficacy of preoperative administration of acetaminophen and melatonin on Retrobulbar Block associated pain in cataract surgery
Anesthesiology and Pain Medicine, 2018Co-Authors: Soudabeh Haddadi, Reyhaneh Shahrokhirad, Malek Moien Ansar, Shideh Marzban, Mitra Akbari, Arman ParviziAbstract:Background: Retrobulbar Block is one of the chosen methods for local anesthesia in cataract surgery. Since it is a painful procedure, using analgesic and sedative drugs is recommended. Current medications have side effects and evaluating of new drugs or new uses of existing safer drugs is necessary. Objectives: The aim of this study was to compare the administration of melatonin and acetaminophen on pain and hemodynamic changes during Retrobulbar Block. Methods: In a double-blinded randomized trial, 180 patients undergoing cataract surgery were randomly divided into three groups: Melatonin group (received melatonin 6 mg), acetaminophen group (received acetaminophen 500 mg), and control group (received placebo). All drugs were administered orally 60 min before arrival to the operating room by nurses blinded to the drugs administered. All patients received fentanyl 0.5 μg/kg before Retrobulbar Block intravenously. Hemodynamic variables and pain score in each patient were evaluated on arrival in the operating room, during Retrobulbar Block, during surgery, 20 min after operation, at the end of surgery, and in the recovery room. In case of pain score more than three, additional fentanyl was administered. All data were recorded in structured data sheets. Results: Data analysis indicated no significant differences among the groups at baseline on any of the demographic variables. Both acetaminophen and melatonin reduced the pain score significantly compared with control during Retrobulbar Block (P < 0.05 and P < 0.01, respectively). Administration of additional fentanyl was significantly lower in the melatonin group than the control group (P < 0.05). Hemodynamic changes were not significantly different among all groups. Conclusions: For the first time, as far as we have studied, the analgesic effect of acetaminophen on the Retrobulbar Block was indicated. We also showed that melatonin can reduce pain during Retrobulbar Block leading to reduction of additional fentanyl during operation. It seems that both melatonin and acetaminophen may have a beneficial effect on pain control in the Retrobulbar Block.
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comparing the effect of topical anesthesia and Retrobulbar Block with intravenous sedation on hemodynamic changes and satisfaction in patients undergoing cataract surgery phaco method
Anesthesiology and Pain Medicine, 2015Co-Authors: Soudabeh Haddadi, Shideh Marzban, Arman Parvizi, Baharak Fazeli, Abtin Heidarzadeh, Bahram Naderinabi, Mohamad Reza Panjtan PanahAbstract:BACKGROUND: Cataract is one of the most common surgical procedures in the elderly. In most cases, the elderly have cardiac ischemia or chronic coronary diseases, which would lead to more ischemic events during general anesthesia. Therefore, surgeons and anesthetists prefer regional aesthesia to the general one owing to its more advantages and less complications. OBJECTIVES: Therefore, this study aimed to compare topical method and Retrobulbar Block for pain intensity, patient's satisfaction, hemodynamic changes and intra and postoperative complications. PATIENTS AND METHODS: In a single-blinded clinical trial, 114 patients scheduled for cataract surgery, aged 50 to 90 years with ASA physical status of I-III, were randomly assigned to two groups under monitored anesthesia care as topical anesthesia and Retrobulbar Block. After the injection of intravenous sedation, which was the combination of midazolam 0.5-1 mg with fentanyl 0.5-1 µ/kg, patients received retro bulbar Block or topical anesthesia. During the operation, heart rate, systolic and diastolic blood pressure, mean arterial blood pressure and arterial saturation of O2were measured every five minutes. In addition, pain (VAS) and satisfaction (ISAS) scores were recorded every 15 minutes, then at recovery and one hour after the ending of operation in the ward. Findings were statistically analyzed using SPSS 16. RESULTS: In this study, no significant association was found between age, gender, education and physical condition of patients in both topical and retro bulbar Block groups. Comparison of pain based on VAS, satisfaction based on ISAS score and MAP in the studied periods had no significant differences between the two groups of patients undergoing cataract surgery. However, significant differences were found between the two groups (P = 0.045, 0.02, 0.042 and P < 0.05) regarding heart rate, systolic and diastolic blood pressure and arterial oxygen saturation percentage after 20-30 minutes of the operation. CONCLUSIONS: Both methods, topical and retro bulbar Block had similar impression in cataract surgery regarding analgesia and patient satisfaction. However, in non-complicated cataract surgeries with short duration, topical anesthesia may be the preferable method, because of non-invasiveness, appropriate analgesia, patient satisfaction and hemodynamic stability.