Dexamethasone bupivacaine versus bupivacaine for peribulbar block in posterior segment eye surgery

Aim: The study conducted aims to assess the efficacy, time to first analgesic request, and postoperative inflammatory response after adding dexamethasone to local anesthetic mixture for a peribulbar block in posterior segment eye surgery. Patients and methods: A double-blind randomized study was carried out on 50 ASA I and II patients scheduled for elective posterior segment surgery (vitreoretinal). Patients were allocated randomly into two groups, 25 patients in each group. Group I received equal volumes of 10 ml of a l: 1 mixture of bupivacaine 0.5% and saline, supplemented with 4 mg dexamethasone in 1 ml saline and group II received the same local anesthetic mixture (total volume 10 ml) without adding dexamethasone. The duration and onset of motor block, time to first analgesic request, postoperative inflammatory response, and other side effects such as nausea and vomiting were assessed. Results: Patients receiving peribulbar block were significantly pain free by end of surgery (0 h) (P < 0.05) and throughout the postoperative period in the dexamethasone group at 2 and 6 h postoperatively. The number of patients requiring rescue analgesics was significantly lower with dexamethasone bupivacaine block (P < 0.05). The incidence of postoperative nausea and vomiting was significantly less in the first group (I) in comparison to the other group (II) (P < 0.05) and lastly the level of C reactive protein postoperatively was found to be significantly less in the dexamethasone group than the other one (P < 0.0001). Conclusion: Adding dexamethasone to bupivacaine in peribulbar block appears to be a safe and clinically superior adjuvant with less postoperative pain, inflammatory response in patients undergoing posterior segment eye surgery. (C) 2013 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Anesthesiologists. Open access under CC BY-NC-ND license.