الفهرس 
ANATOMICAL CONSIDERATIONS FOROnly 14 pages are availabe for public view
 |  | from | 107 |  |  |
| | | from | 107 | | |
Abstract
Abstract
Background: The use of additives for peribulbar anesthesia is favored due to various benefits towards analgesia, akinesia and concurrent sedative effects. Objective: The aim of this work was to study the effect of addition of clonidine versus dexmedetomidine to lidocaine bupivacaine mixture in peribulbar block for keratoplasty as regard efficacy, safety and satisfaction of the patient Patients and methods: This prospective, controlled, randomized, blinded, clinical study was carried out on 75 patients scheduled for keratoplasty under local anesthesia. All patients received equal volume of the tested anesthetic mixture vial a simple inferotemporal peribulbar injection. group B (control group): 0.5% Bupivacaine plus 2% lidocaine. group C: 0.5% Bupivacaine plus 2% lidocaine plus 1μg/kg clonidine. group D: 0.5% Bupivacaine plus 2% lidocaine plus 1μg/kg dexmedetomidine. Results: there was a statistically significant reduction in onset time of akinesia with better perioperative analgesia, sedation and patient satisfaction when adding dexmedetomidine to LA mixture compared to adding clonidine to LA mixture. In addition, both were also better than using LA mixture alone with statistically more reduction in MAP and heart rate in dexmedetomidine group followed by clonidine group then control group. Conclusion: Dexmedetomidine when added to LA mixture as an adjuvant in peribulbar block for keratoplasty produces faster onset of motor akinesia and better perioperative analgesia with higher sedation level and patient satisfaction when compared to clonidine when added to the same mixture. Also, it possesses a greater effect in reducing mean arterial blood pressure (MAP) and heart rate than clonidine with no effect on respiratory rate and peripheral oxygen saturation same as clonidine.