Dexmedetomidine, propofol or midazolam for sedation in patients undergoing vitreoretinal surgery under peribulbar block / Mayada Khairy Mohammad Yassen ; Supervised Hoda Hassan Okasha , Wafaa Saad Hamdy , Gehan Mohammad Obaya

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Vitrectomy differs from routine ophthalmic operations in these, amongst others, include long duration of surgery, operating in darkness, overcrowding of the theatres, and inaccessibility of the patient during surgery. Many patients, particularly elderly ones, suffer from intercurrent disease. Although the surgery is of a relatively urgent nature, conditions like congestive failure or active chest infections should be treated.The peribulbar block seems to replace the retrobulbar block to some extent due to less incidence of complications.⁽¹¹⁾ The peribulbar, or extraconal block, placed further from the optic and other orbital nerves, requires larger volumes of local anesthetic and has longer latency of onset. The needle entry point for the block is at the inferotemporal location. The junction of the lateral third and medial two - thirds of the inferior orbital rim in line with the lateral limbal margin has been the conventional access point ²⁸

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