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Re-evaluation of hyaluronidase in peribulbar anaesthesia
D P Prosser1, G E Rodney, T Mian
1Glan Hafren NHS Trust Hospitals, Newport, Gwent.
The British Journal of Ophthalmology
|September 1, 1996
Summary
Adding hyaluronidase to local anaesthetic mixtures for peribulbar anaesthesia does not significantly speed up the onset of globe akinesia. This study found no significant difference in anaesthesia onset time with or without hyaluronidase.
Area of Science:
- Ophthalmology
- Anaesthesiology
- Pharmacology
Background:
- Hyaluronidase is known to enhance local anaesthetic efficacy.
- Previous observations suggest adequate peribulbar anaesthesia is achievable without hyaluronidase.
- A randomized controlled trial was designed to evaluate this.
Purpose of the Study:
- To determine if hyaluronidase addition to local anaesthetic mixtures significantly reduces onset time for peribulbar anaesthesia.
- To compare the efficacy of local anaesthetic mixtures with and without hyaluronidase.
Main Methods:
- A randomized double-blind study involving 50 patients undergoing peribulbar anaesthesia.
- Patients received a standard local anaesthetic mixture (bupivacaine and lignocaine) with or without hyaluronidase (25 IU/ml).
- The primary outcome measured was the time to achieve satisfactory globe akinesia for surgery.
Main Results:
- The mean onset time to globe akinesia was 5.64 minutes in the control group and 4.64 minutes in the hyaluronidase group.
- Onset times ranged from 2 to 15 minutes (control) and 2 to 12 minutes (hyaluronidase).
- Statistical analysis (Mann-Whitney test) showed no significant difference between groups (p = 0.6).
Conclusions:
- The addition of 25 IU/ml hyaluronidase to a standard local anaesthetic mixture does not significantly shorten the onset time for globe akinesia in peribulbar anaesthesia.
- These findings suggest hyaluronidase may not be essential for achieving timely and satisfactory peribulbar anaesthesia.