Compare the efficacy of dexmedetomidine as an adjuvant to peribulbar block for vitrectomy.

Abstract

Ophthalmic surgeries, such as vitrectomy, are becoming more common, with anesthesia choice primarily depending on the procedure's duration. Peribulbar block is a safe option that reduces complication risks. In this context, dexmedetomidine has been used as an adjunct to prolong analgesia and block. This study aimed to evaluate the efficacy of dexmedetomidine in peribulbar block during vitrectomy. A multicenter, prospective, comparative, double-blind study was conducted with 27 patients aged 18 to 80 years (ASA I-II), randomized into two groups: group A (13 patients) received bupivacaine 0.5% 15 mg, lidocaine 5% 100 mg, and hyaluronidase 75 UD; group B (14 patients) received the same drugs plus 50 μg dexmedetomidine. Vital signs, pain, rescue analgesia, and side effects were recorded. Group B showed better pain control, with 86% of patients pain-free compared to 46% in group A at 30 minutes (p=0.046). Group B also had a significantly longer duration without needing rescue analgesia (138.93 ± 94.4 minutes). Hypertension episodes were observed in group A (p=0.03). The dexmedetomidine group showed greater analgesic benefit and an acceptable safety profile, making it the most effective and suitable alternative.