Adjuvants to local anaesthesia in ophthalmic surgery

Area of Science:

• Ophthalmology
• Anesthesiology
• Pharmacology

Background:

• Adjuvants are frequently used with local anesthesia in ophthalmic regional anesthesia.
• Various agents including hyaluronidase, bicarbonate, epinephrine, muscle relaxants, opiates, and clonidine have been studied.
• There is no established consensus on the optimal use of these adjuvants.

Purpose of the Study:

• To review the efficacy of adjuvants in ophthalmic regional anesthesia.
• To evaluate improvements in akinesia, analgesia, speed of onset, and reduction of block failure.
• To provide data to support informed decision-making regarding adjuvant selection.

Main Methods:

• Review of pharmacological actions of common adjuvants.
• Analysis of randomized control trials evaluating adjuvant efficacy.
• Examination of dosages and relevant literature.

Main Results:

• Adjuvants demonstrate varied effects on akinesia, analgesia, onset speed, and block failure rates.
• Specific agents and combinations show potential benefits but lack universal agreement.
• Pharmacological actions provide a basis for understanding efficacy.

Conclusions:

• Current data on adjuvants for ophthalmic regional anesthesia is extensive.
• Lack of consensus necessitates informed choices based on available evidence.
• Further research may clarify optimal adjuvant strategies.