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Year : 2019  |  Volume : 47  |  Issue : 1  |  Page : 33-38

Comparative study between cisatracurium, atracurium as an adjuvant agent to local anesthetics on peribulbar anesthesia in adult healthy patients

Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt

Correspondence Address:
Marwa M Elgohary
Surgical Intensive Care, Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, 10 Masged El Eeda St. from Reyad Ghoraba, Tanta, El-Gharbia
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DOI: 10.4103/tmj.tmj_42_17

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Background Patients with cataracts tend to be older and to have serious comorbidities and there is evidence that local anesthetic causes fewer adverse events than general anesthesia as well as reduces the recovery time of the patient. Many adjuvant drugs have been shown to improve the quality of peribulbar anesthesia. Aim The aim was to compare the effect of using atracurium and cisatracurium as an adjuvant to local anesthetic on peribulbar anesthesia in cataract surgeries. Patients and methods A total of 90 patients of both sexes belonging to the American Society of Anaesthesiology I and II status scheduled for cataract surgery using peribulbar anesthesia were divided into three equal groups as follows. Group I: received only bupivacaine and lidocaine, group II received bupivacaine+lidocaine+atracurium, and group III patients received bupivacaine+lidocaine+cisatracurium. Results There was a significant increase in time to begin surgery in group I when compared with groups II and III (P=0.001). There was a statistically significant difference (P=0.001) in akinesia score at 1, 3, 5, 7, and 10 min between groups. Also, there was a statistically significant difference (P=0.001) in eyelid squeezing score at 1, 3, 5, 7, and 10 min between groups. There was an increased number of patients who required supplementary dose in group I (33.3%) than in groups II (10%) and group III (10%) (P=0.024). Rapid offset of akinesia occurred in group I than in group II and group III (P=0.001). Intraoperative pain using the visual analog scale score was statistically insignificant (P>0.05) between groups. There was no statistical difference between groups I, II, and III regarding complications and adverse effects. Conclusion Addition of muscle relaxant (atracurium or cisatracurium) in peribulbar anesthesia provides better akinesia, rapid onset, and more prolonged time of akinesia; it also decreases the need for supplementary injection.

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