The role of Hyaluronidase in periocular anaesthesia

Abstract

Injectable anaesthesia of any kind inherently has risks related to needle. Eversince development of retrobulbar anaesthesia and the recognition of its potential hazards, continuous effort was done to develop a safer technique to block the orbit, and yet at the same time without sacrificing the undoubted high efficacy of retrobulbar blocks. Although, periocular blocks fulfill these criteria with . reasonable success, many surgeons are still using the less safe technique. They claim that the periocular blocks cause undesirable ballooning of the eyelids and significant chemosis of the conjunctiva. They also add that hyaluronidase is a must if we are to use such large volumes in blocking the orbit by the periocular technique. Reviewing the . literature , we found that •the role of hyaluronidase in periocular blocks is a matter of debate. Encouraged by the conflict, we decided to perform a clinical study to answer the question of what hyaluronidase can do? We studied the effect of hyaluronidase on periocular blocks in terms of: ,.,• (!)Onset of block. (2)Duration of block. (3)Need for supplementation. (4)Level ofiOP: . *1 minute following injection. • * 10 minutes following injection. We also recorded complications, patient and surgeon satisfaction qualitatively.