IS HYALURONIDASE HELPFUL FOR PERIBULBAR ANESTHESIA

A prospective, randomised controlled study was performed to investigat e whether hyaluronidase improved the efficacy of peribulbar anaesthesi a. Ninety-two patients undergoing peribulbar anaesthesia for intraocul ar surgery all received 10 mi of an anaesthetic solution consisting of a 50:50 mixture of 2% lignocaine with I in 200 000 adrenaline and 0.5 % bupivacaine, Patients were randomised to a hyaluronidase group which received 150 IU/ml hyaluronidase in this anaesthetic solution (a high er concentration than previous studies) or a control group which recei ved no hyaluronidase. There were 44 patients in the hyaluronidase grou p and 48 patients in the control group, All anaesthetic injections wer e administered by an experienced ophthalmologist and no supplementary injections were required in any case, The mean time interval between a dministration of the block and commencement of surgery was 22 minutes, No statistically significant difference was found between the two gro ups for pre-operative akinesia (p = 0.16), intraoperative akinesia (p = 0.25), eyelid paralysis (p = 0.72), objective analgesia (p = 0.23) o r subjective analgesia (p = 0.60). The majority of patients in both gr oups achieved excellent akinesia, eyelid paralysis and analgesia, The reasons for these findings in the light of previously conflicting repo rts on the value of hyaluronidase in peribulbar anaesthesia are discus sed.