Ketamine versus magnesium sulphate as an adjuvant to local anesthetics in the peribulbar block for posterior segment surgeries : )A randomized controlled study / Eslam Mohamed Saleh ; Supervised Nadia Yousef Hamed Helmy , Rehab Mohamed Sami , Tamer Mohammed Kheir

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

Background and objectives: The use of an adjuvant to local anesthetics in the peribulbar block may improve the block characteristics.The aim was to evaluate the effect of ketamine or magnesium sulphate as an adjuvant to a local anesthetic mixture on onset, duration, and quality of peribulbar block for patients scheduled for posterior segment surgeries Study design: A randomized controlled study on 126 patients scheduled for vitreoretinal surgery were randomly allocated to one of three equal groups to receive either saline [GC, n=42], ketamine [(25mg) GK, n=42] or magnesium sulfate [(50mg) GM, n=42] added to equal volume of 2% lidocaine and 0.5% bupivacaine containing 135IU of hyaluronidase during peribulbar block. Results: As compared to control group, the use of either ketamine or magnesium as local anesthetic adjuvant signi{uFB01}cantly fastened the onset of globe akinesia (3.31 ± 1.87min) (3.38 ± 1.62min), minimized the time required to start surgery (5.55 ± 1.52min) (6.36 ± 1.43min), enhanced the onset of sensory block (2.12 ± 1.02 min) (2.52 ± 1.38 min) prolonged the duration of lid akinesia (143.12 ± 28.46min) (260.10 ± 19.34min), increased the duration of globe akinesia (161.57 ± 31.18min) (277.64 ± 21.82min), and increased the total analgesic time (187.43 ± 38.07min) (294.71 ± 20.12min) (P < .05). However, neither ketamine nor magnesium had a signi{uFB01}cant e{uFB00}ect on the intraocular pressure (P > .05).Patient and surgeon satisfaction were signi{uFB01}cantly higher in both ketamine and magnesium groups compared to control group (P < .05)

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