Ophthalmic artery resistance index after peribulbar block in the presence of epinephrine

• Published in: International ophthalmology 2021, Vol.41 (1), p.203-210
• Main Authors: Machado, Ilma Patrícia, Vasconcelos, Galton Carvalho, Lopes, Rodrigo Souza, Gomez, Renato Santiago
• Format: Article
• Language: English
• Subjects: Cataracts; Epinephrine; Evaluation; Eye diseases; Eye surgery; Hypertension; Lidocaine; Medicine; Medicine & Public Health; Ophthalmology; Original Paper; Surgery; Velocity
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-020-01567-2

Purpose There are controversies regarding ophthalmic artery (OA) flow after peribulbar block in the presence of epinephrine. Therefore, we aimed to evaluate OA flow via echo-Doppler before and after peribulbar block with lidocaine in the presence or absence of epinephrine. Methods Fifty-six patients who had an American Society of Anesthesiologists (ASA) classification of I, II or III and were eligible for cataract phacoemulsification surgery were selected. Patients with other eye diseases were excluded. Patients were divided into two groups: group 1—peribulbar block with lidocaine and 1/200,000 epinephrine; group 2—peribulbar block with lidocaine in the absence of epinephrine. The resistance index (RI), peak systolic velocity (PSV), end diastolic velocity (EDV) of the OA were evaluated using echo-Doppler before and 10 min after the peribulbar block. Results No differences between groups were observed in the RI before the peribulbar block as well regarding the presence of hypertension and the age or gender of the patient. After the peribulbar block, we observed a decrease in the RI in group 1 ( p  = 0.038, Cohen’s d  = 0.336) and no difference in the RI in group 2 ( p  = 0.109, Cohen’s d  = 0.172). When comparing group 1 and group 2, we observed a decrease in the RI in group 1 ( p  = 0.028, Cohen’s d  = 0,583). There was no difference between groups regarding the PSV and EDV after the peribulbar block. Conclusions A decrease in RI was observed in the OA after peribulbar block with a vasoconstrictor, an effect that could be a benefit in some ocular surgeries.