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Effect of different fentanyl concentrations added to local anesthetic mixture in peribulbar block on pain experience and cooperation of patients during training residents' phacoemulsification

Poster Details

First Author: H.Elmekawey EGYPT

Co Author(s):    I. Kamel   A. Mounier   A. Zaglol   I. Saied     

Abstract Details



Purpose:

Evaluation of the effect of different concentrations of fentanyl added to the local anesthetic mixture on pain expression and patients' cooperation during phacoemulsification by training residents.

Setting:

Kasr Al Aini hospital, Cairo University, Egypt.

Methods:

Double blinded randomized controlled clinical trial. 60 patients with cataract grade 1 to ASA grade I, II and III, scheduled for elective phacoemulsification under regional anesthesia. They were randomly divided into four groups, in Group 1 (Control Group), patients received Lidocaine 2% and Hyaluronidase 15 IU/ml. In Groups 2, 3 and 4 (Fentanyl Groups), the patients received Lidocaine 2% and Hyaluronidase 15 IU/ml in addition to Fentanyl 1 μg/ml, 2 μg/ml and 3μg/ml respectively. Every patient was graded using a visual analogue scale (VAS) from 0 (no pain) to 10 (unbearable pain) after the surgery. The cooperation of the patient was graded from 0 (no event) to 3 (marked lids and eye squeezing) by the surgeon.

Results:

no statistically significant difference between the four groups in the onset and duration of lid and globe akinesia. There was a significant difference between the control group and the fentanyl groups as regard the duration of analgesia. In the control group and fentanyl 1μg/ml group, the patients' analgesia lasts for 100-103 minutes from the local anesthetic injection, while it lasts for 116±19 minutes and 144±11 minutes in the fentanyl 2μg/ml group, and 3μg/ml group, respectively.

Conclusions:

Local peribulbar Fentanyl injection in combination with Lidocaine and Hyaluronidase is a safe and effective method in prolonging analgesia and improving patients cooperation during lengthy phacoemulsification done by training residents. FINANCIAL INTEREST: NONE

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