Abstract :
Since many years anesthesia for an eye evolving from retrobulbar to topical. Hyaluronidase is use for
better absorption of anesthetic solution. Due to the enzyme nature of hyaluronidase, cost of the drug, risk
of anaphylaxis and limited shelf life led the search of newer molecule which gives better absorption with
negligible risk and cost effectiveness. As commercially available local anesthetic agents are more acidic
in nature causing more pain to patients and so this study compare the pain perception by buffering the
anesthetic agents with sodium bicarbonate 7.5%.
Objective: To estimate the pain perception of preservative free sodium bicarbonate (7.5%), lignocaine 2
%, bupivacaine 0.5% with hyaluronidase (1500IU) in combination of lignocaine 2% and bupivacaine 0.5%
for peribulbar anesthesia.
Materials and Methods: Prospective interventional study was done on 60 patients over a period of 12
months. Patients were selected randomly who falls under inclusion criteria and were injected freshly
prepared non-buffered (solution-A) or buffered (solution-B) peribulbar anaesthesia. The pH of both
solutions was tested using digital pH meter at the same time. All peribulbar injections were given by
one surgeon only. The pain of peribulbar injection were noted on Wong- Baker FACES20 pain rating scale
during each block. Results were analyzed by independent t - test.
Results: Both the group consist of 30 patients each. 34 were male and 26 were female. Mean pH of
solution A: 6.18 0.13 and of solution B: 7.18 0.14. In first group that is without sodium bicarbonate
40% of patient were having a moderate pain with mean pain score 4.033 2.12 and 6.66% of patient were
having moderate pain with mean pain score 1.43 1.40 in the second group (with sodium bicarbonate).
Statistical analysis shows P value 0.00001, which was highly significant.
Keyword :
Sodium bicarbonate, Hyaluronidase, Peribulbar anesthesia, Pain score Introduction.