PubMed Kapalı Erişimli Yayınlar

Permanent URI for this collectionhttps://hdl.handle.net/11727/10764

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    Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery
    (2020) Oleshchenko, Irina; Cok, Oya Yalcin; Iureva, Tatiana; Zabolotskii, Dmitrii; Kripak, Anna; 0000-0003-3004-2626; 31964855; AAI-7998-2021
    Background General anesthesia is required to perform pediatric cataract surgery. To reduce severity of surgical intervention and postoperative complications, regional techniques have been concomitantly used. The traditional regional ophthalmic techniques are retrobulbar, peribulbar and sub-Tenon blocks, which present some technical difficulties and associated complication risks. The pterygopalatine blockade has been exempt of many of these concerns as it is performed out of the orbit. The purpose of this study was to compare the analgesic and anti-inflammatory effects of the pterygopalatine blockade with retrobulbar block in children undergoing elective congenital cataract surgery. Methods After approval of ethics committee and informed consents, patients were enrolled to the study to have either ultrasound-guided pterygopalatine block (group P) or retrobulbar block (group R), with 2 mL lidocaine 2% and 1 mL ropivacaine 0.5%. Hemodynamic monitoring was recorded throughout the perioperative period. Cortisol level and oxidation-reduction status were assessed before and after surgery. Pain and inflammatory response (Tyndall effect, corneal syndrome and edema) were assessed on the first postoperative day. Results Comparative analysis demonstrated a decrease in cortisol of 123.24% (p<0.05) and an increase in the redox coefficient of 37.7% (p<0.05) in group P. Pain intensity was significantly higher in group R until the 16th postoperative hour. The corneal syndrome in patients in group P and group R was noted by 7.6% and in 32.1%, respectively (p<0.05). Conclusion The use of the pterygopalatine blockade as a component of anesthesia in pediatric cataract surgery allows reduction of the severity of surgical stress during surgical intervention, providing intraoperative hemodynamic stability and prolonged analgesia.
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    Lacrimal dilator-facilitated incisionless vs. standard sub-Tenon's block: a randomized, prospective and non-inferiority comparative study
    (2020) Coban-Karatas, Muge; Cok, Oya Yalcin; Kumar, Chandra M; 0000-0003-3004-2626; 33005046; AAI-7998-2021
    Background/objectives Standard sub-Tenon's block (STB) involves incision (dissection) of conjunctiva and Tenon's capsule with the help of blunt scissors and forceps, insertion of a blunt sub-Tenon's cannula under the Tenon's capsule and injection of local anaesthetic agent. STB is frequently associated with minor complications such as chemosis and postoperative subconjunctival haemorrhage but rare sight and life-threatening complications. To reduce these minor complications, several variations of incisionless STB have been described however, there are no comparative data. One such incisionless STB involves the use of lacrimal dilator which is easily available in the operating theatre. We compared incisionless lacrimal dilator-facilitated with the standard STB for effectiveness, chemosis, and postoperative subconjunctival haemorrhage. Subjects/methods After obtaining ethical approval, patients scheduled to undergo elective phacoemulsification cataract surgery were enroled to receive incisionless lacrimal dilator-facilitated STB (Group LD) or a standard STB using Wescott scissors and blunt forceps (Group WS). All patients received 3 mL 2% lidocaine without any adjuvant. No sedation was administered. Demographics of the patients, duration of the procedure, analgesia, akinesia, duration of the procedure intraoperative chemosis, and postoperative subconjunctival haemorrhage were compared. Results Both groups were comparable for demographic data, duration of the procedure, analgesia, and akinesia (p > 0.05). The severity of chemosis and postoperative subconjunctival haemorrhage were significantly lower in Group LD (n = 32) in comparison to Group WS (n = 31) (p < 0.001). Conclusions Incisionless lacrimal dilator-facilitated STB decreases intraoperative chemosis and postoperative conjunctival haemorrhage in comparison to standard STB. Analgesia and akinesia are comparable in both techniques.