British Journal of Anaesthesia, Vol 78, Issue 6 671-674, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia
G. A. Dempsey, P. J. Barrett and I. J. Kirby
We have assessed the effect of two concentrations of hyaluronidase on the
quality of peribulbar block, using a low volume, single injection
technique. We studied 200 patients undergoing elective intraocular surgery,
allocated randomly to one of three groups. Group 1 (n = 50) received
peribulbar block with 5 ml of a 1:1 mixture of 0.5% plain bupivacaine and
2% plain lignocaine. Group 2 (n = 75) received this solution supplemented
with hyaluronidase 50 iu ml-1. Group 3 (n = 75) received the same solution
supplemented with hyaluronidase 300 iu ml-1. Lack of ocular motility was
considered to be the only objective sign of successful block and movement
of each rectus muscle was scored at 1-, 5- and 10-min intervals. If the
block was successful at 5 min, the 10-min score was omitted. If the block
was unsuccessful at 5 min, a second injection of 2% lignocaine 3 ml was
given and additional assessments performed at 5-min intervals. At 1 min,
ocular motility scores were significantly lower in group 3 compared with
the control group (P < 0.05). The incidence of satisfactory block at 5
min was increased in both groups given hyaluronidase (group 2, P < 0.05;
group 3, P < 0.001). There were no significant differences between
groups 2 and 3 with respect to quality of block at 5 min. Hyaluronidase in
both concentrations improved the quality of peribulbar block at 5 min, and
when used in a concentration of 300 iu ml-1, also improved the speed of
onset of block.
CLINICAL INVESTIGATIONS
Hyaluronidase and peribulbar block
Aintree Hospitals NHS Trust, Liverpool; FRCA, Southport Hospitals NHS Trust, Southport
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