Single-injection peribulbar block combined with general anesthesia in children undergoing ophthalmic surgery: A randomized controlled study

Background: The present study evaluated the efficacy and safety of single injection technique for peribulbar block using a short needle and a small volume as adjuvant to general anesthesia in children undergoing ophthalmic surgery. The aim was to reduce complications accompanying general anesthesia and to improve postoperative outcome. Method: Forty children aged 6-12 years, ASA I or II scheduled for ophthalmic surgery were included in the study. Children were randomly allocated into two equal groups (n = 20) to receive either general anesthesia alone (GA group) or single injection peribulbar block in conjunction with general anesthesia (GA-PB group). Peribulbar block was performed using single injection of 3-4 ml of 2% lidocaine-hyaluronidase mixture (10 IU/ml) and 0.5% bupivacaine with a ratio of (1: 1), with a 28G, 12 mm needle. Intraoperative heart rate and mean arterial pressure, incidence of oculocar-diac reflex (OCR) and number of patients required fentanyl were recorded. Postoperative nausea and vomiting (PONV), time to first rescue analgesic and number of patients who required rescue analgesia were reported. Results: No patient developed OCR or required intraoperative analgesic supplements in GA-PB group compared to 11 (55%) and 5 (25%) patients, respectively, in GA group (p < 0.05 and p < 0.05 respectively). Intraoperative HR and MAP measures were significantly reduced in GA-PB group compared with GA group (p < 0.05). A significantly lower incidence of PONV was recorded in GA-BP group versus GA group (p < 0.05). The time to first rescue analgesic was significantly longer in GA group than GA-PB group (p < 0.05). The number of patients who required rescue analgesia in the first postoperative 12 h was significantly higher in GA group compared to GA-PB group. No serious complication was recorded in GA-PB group. Conclusion: Single injection, peribulbar block using a short needle and a small volume is a safe and effective technique when combined with general anesthesia in pediatric ophthalmic surgery. (C) 2011 Egyptian Society of Anesthesiologists. Production and hosting by Elsevier B.V.