Is hyaluronidase helpful for peribulbar anaesthesia?

Area of Science:

• Ophthalmology
• Anesthesiology
• Pharmacology

Background:

• Peribulbar anesthesia is commonly used for intraocular surgery.
• The role of hyaluronidase in enhancing peribulbar anesthesia efficacy is debated.
• Previous studies have yielded conflicting results regarding hyaluronidase's benefits.

Purpose of the Study:

• To investigate if hyaluronidase improves the efficacy of peribulbar anesthesia for intraocular surgery.
• To compare outcomes between patients receiving peribulbar anesthesia with and without hyaluronidase.
• To assess the impact of a higher concentration of hyaluronidase.

Main Methods:

• Prospective, randomized controlled study involving 92 patients undergoing intraocular surgery.
• Patients received a standard anesthetic solution (lignocaine, adrenaline, bupivacaine).
• Intervention group received 150 IU/ml hyaluronidase; control group did not. Outcomes measured: pre-operative and intraoperative akinesia, eyelid paralysis, objective and subjective analgesia.

Main Results:

• No statistically significant differences were observed between the hyaluronidase and control groups for any measured outcome (akinesia, eyelid paralysis, analgesia).
• P-values for pre-operative akinesia (0.16), intraoperative akinesia (0.25), eyelid paralysis (0.72), objective analgesia (0.23), and subjective analgesia (0.60) indicated no significant effect.
• The majority of patients in both groups achieved excellent akinesia, eyelid paralysis, and analgesia.

Conclusions:

• The addition of hyaluronidase at a concentration of 150 IU/ml to peribulbar anesthesia did not enhance its efficacy for intraocular surgery.
• High-quality anesthesia and analgesia were achieved in most patients regardless of hyaluronidase use.
• Findings contribute to the ongoing discussion on hyaluronidase's utility in regional anesthesia for ophthalmic procedures.