Subtenon and Intravenous Dexmedetomidine Effect on Patients Undergoing Cataract Surgery

NCT ID: NCT04668456

Last Updated: 2021-02-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-15

Study Completion Date

2021-03-30

Brief Summary

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The study designed to compare the effects and the safety of adding dexmedetomidine to local anesthetics and its intravenous administration in subtenon block in patients undergoing cataract surgery.

Detailed Description

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Ophthalmological surgery can be performed under topical, regional or general anesthesia. Recently, the majority of ocular surgeries performed by regional rather than general anesthesia, because of the regional anesthesia is more economic, easy to perform, and the risk involved is less. Orbital regional anesthesia can be done using a retrobulbar (intra-conal) block, peribulbar (extra-conal) block or sub-Tenon's block.

The STBs or episcleral block was first described by Turnbull in 1884 and it was repopularized in the 1990s as a simple and safe alternative to needle-based eye blocks. The STB becomes the most widely practiced regional technique for cataract surgery, because it produces satisfactory anesthesia for most intraocular procedures, and avoids the inherent risks of needle-based blocks, such as globe perforation and optic nerve injury.

Dexmedetomidine is a selective α-2 receptor agonist that produces sedation and analgesia without causing respiratory depression. It also allows patients to respond to verbal commands during the sedation; easy conversion from sleeping to awakening is possible. Therefore, dexmedetomidine has been used as sedative in various clinical fields in intensive care unit and surgery and an adjuvant to local anesthetics.

Many studies were done to evaluate its effect as sedative or anlgesic when administered either intravenously or when added to local anesthesia in ophthalmic block. But no one, till now comparing its effect when used as adjuvant to local anesthetics or administered intravenously in subtenon block.

Conditions

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Acute Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

75 Patients were assigned into three equal groups, all patients received 2.5 ml of local anesthetic mixture through subtenon block and IV infusion of drugs as follows: Group C (control group): received subtenon LA mixture of bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml)+ saline 0.9% (0.5 ml) and IV infusion of saline 0.9% over 10 min. before subtenon block.

Group SD ( subtenon dexmedetomidine): received subtenon LA mixture of bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml)+ 0.5 μg/kg dexmedetomidine (0.5 ml) and IV infusion of saline 0.9% over 10 min. before subtenon block.

Group ID (iv dexmedetomidine): received received subtenon LA mixture of bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml)+ saline 0.9% (0.5 ml) and IV infusion of 0.5 μg/kg dexmedetomidine over 10 min. before subtenon block.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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Group C (control group)

Group C (control group): received subtenon LA mixture of bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml)+ saline 0.9% (0.5 ml) and IV infusion of saline 0.9% over 10 min. before subtenon block.

Group Type PLACEBO_COMPARATOR

lidocaine 2%

Intervention Type DRUG

subtenon injection

bupivacine 0.5%

Intervention Type DRUG

subtenon injection

Normal saline

Intervention Type DRUG

either subtenon or iv

Group SD (subtenon dexmedetomiine)

Group SD ( subtenon dexmedetomidine): received subtenon LA mixture of bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml)+ 0.5 μg/kg dexmedetomidine (0.5 ml) and IV infusion of saline 0.9% over 10 min. before subtenon block.

Group Type ACTIVE_COMPARATOR

Dexmedetomidine

Intervention Type DRUG

the drug administered either subtenon ot iv

lidocaine 2%

Intervention Type DRUG

subtenon injection

bupivacine 0.5%

Intervention Type DRUG

subtenon injection

Normal saline

Intervention Type DRUG

either subtenon or iv

Group ID (iv dexmedetomidine)

Group ID (iv dexmedetomidine): received received subtenon LA mixture of bupivacaine 0.5% (1 ml) + lidocaine 2% (1 ml)+ saline 0.9% (0.5 ml) and IV infusion of 0.5 μg/kg dexmedetomidine over 10 min. before subtenon block.

Group Type ACTIVE_COMPARATOR

Dexmedetomidine

Intervention Type DRUG

the drug administered either subtenon ot iv

lidocaine 2%

Intervention Type DRUG

subtenon injection

bupivacine 0.5%

Intervention Type DRUG

subtenon injection

Interventions

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Dexmedetomidine

the drug administered either subtenon ot iv

Intervention Type DRUG

lidocaine 2%

subtenon injection

Intervention Type DRUG

bupivacine 0.5%

subtenon injection

Intervention Type DRUG

Normal saline

either subtenon or iv

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* ASA grade I-III
* Aged 18-70 years
* Both sex
* Scheduled for elective phacoemulsification cataract surgery

Exclusion Criteria

* Coagulation abnormalities
* Impaired mental status
* Refusal of the patient
* Uncontrolled glaucoma
* Recent surgical procedure on the same eye
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Menoufia University

OTHER

Sponsor Role lead

Responsible Party

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ashraf magdy eskandr

assistant professor of anesthesia, icu

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ashraf magdy Eskandr

Shibīn al Kawm, Monufia Governorate, Egypt

Site Status

Osama A Elmorsy

Shibīn al Kawm, Monufia Governorate, Egypt

Site Status

Sadik A Sadik

Shibīn al Kawm, Monufia Governorate, Egypt

Site Status

Countries

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Egypt

Other Identifiers

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8/8/2020 ANET4

Identifier Type: -

Identifier Source: org_study_id

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