Ophthalmic artery resistance index after peribulbar block in the presence of epinephrine
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ORIGINAL PAPER
Ophthalmic artery resistance index after peribulbar block in the presence of epinephrine Ilma Patrı´cia Machado . Galton Carvalho Vasconcelos . Rodrigo Souza Lopes . Renato Santiago Gomez
Received: 7 December 2019 / Accepted: 17 August 2020 Ó Springer Nature B.V. 2020
Abstract Purpose There are controversies regarding ophthalmic artery (OA) flow after peribulbar block in the presence of epinephrine. Therefore, we aimed to evaluate OA flow via echo-Doppler before and after peribulbar block with lidocaine in the presence or absence of epinephrine. Methods Fifty-six patients who had an American Society of Anesthesiologists (ASA) classification of I, II or III and were eligible for cataract phacoemulsification surgery were selected. Patients with other eye diseases were excluded. Patients were divided into two groups: group 1—peribulbar block with lidocaine and 1/200,000 epinephrine; group 2—peribulbar block with lidocaine in the absence of epinephrine. The I. P. Machado Department of Anesthesiology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil G. C. Vasconcelos Department of Strabismus, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil R. S. Lopes Hospital Felı´cio Rocho, Belo Horizonte, Minas Gerais, Brazil R. S. Gomez (&) Department of Surgery, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Sala 203. Bairro Santa Efigeˆnia, Belo Horizonte, Minas Gerais CEP 30140-072, Brazil e-mail: [email protected]
resistance index (RI), peak systolic velocity (PSV), end diastolic velocity (EDV) of the OA were evaluated using echo-Doppler before and 10 min after the peribulbar block. Results No differences between groups were observed in the RI before the peribulbar block as well regarding the presence of hypertension and the age or gender of the patient. After the peribulbar block, we observed a decrease in the RI in group 1 (p = 0.038, Cohen’s d = 0.336) and no difference in the RI in group 2 (p = 0.109, Cohen’s d = 0.172). When comparing group 1 and group 2, we observed a decrease in the RI in group 1 (p = 0.028, Cohen’s d = 0,583). There was no difference between groups regarding the PSV and EDV after the peribulbar block. Conclusions A decrease in RI was observed in the OA after peribulbar block with a vasoconstrictor, an effect that could be a benefit in some ocular surgeries. Keywords Ocular flow Cataract surgery Peribulbar block Ocular Doppler
Introduction Cataract surgery is the most common surgical procedure in ophthalmology, and the choice of anesthetic technique has a significant effect both economically and in terms of patient health. Since the 1990s,
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anesthetic blocks have become the technique of choice in ophthalmology [1]. Peribulbar block was first described by Davis and Mandel in 1986 as an effective and safe technique and an alternative to retrobulbar anesthesia [2]. In a study analyzing 16,224 blocks, the peribulbar technique proved effecti
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