Fortschritte der Ophthalmologie : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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Fortschr Ophthalmol · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial[Modification of hemodynamic retrobulbar anesthesia effects by different oculopression procedures (with and without orbital compression)].
For studying the influence of orbital compression--an essential component of the clinically used methods of oculopression--on the hemodynamic effects of retrobulbar anesthesia, two series of investigations were performed preoperatively in 40 patients. In series 1, we initially performed retrobulbar anesthesia (RBA) with 5 ml of a bupivacaine/lidocaine mixture with adrenaline. RBA was followed by a 15-min period of suction-cup oculopression (SCO; negative pressure -100 and -150 mmHg in 10 patients each), which represents an experimental "pure" oculopression without compression of orbital tissue. ⋯ After SCO, pio was lowered by an average of 8.5 mmHg, and the ocular blood pressures remained unchanged at the post-injection levels. The perfusion pressures, however, were increased to their initial values, and even beyond in some cases. Thus, the inhibitory effects of RBA on ocular circulation are partially set off by the effects of SCO.(ABSTRACT TRUNCATED AT 250 WORDS)
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Fortschr Ophthalmol · Jan 1990
Randomized Controlled Trial Clinical Trial[Suction cup ocular pressure versus Vörösmarthy oculopression. Biometry differences].
In a 20-min follow-up after oculopression, biometric measurements were taken before, immediately after, and 5, 10, 15 and 20 min after finishing oculopression. Thirty-two eyes were measured by ultrasound using the immersion technique with a 10 MHz A-scan probe. Sixteen cataract patients more than 50 years of age and 16 healthy young subjects up to 30 years of age took part in the study. ⋯ Suction-cup oculopression revealed no distinct changes in these compartments. Nevertheless, 10 min after oculopression, there was no statistically significant difference between the two oculopression techniques. When comparing the age groups, the cataract patients showed more express change than the younger subjects.
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Fortschr Ophthalmol · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial[Eyelid akinesia after various techniques of facial nerve block].
Lid akinesia was investigated after the application of one of three techniques to achieve facial nerve blockade in each of 32 patients undergoing cataract surgery. Modifications of the O'Brien, Atkinson and Lint block techniques were applied in twelve, ten, and ten patients, respectively. Before and 1, 3, 5 and 10 min after administration of 5 ml 1% lidocaine (Xylocain) with naphazolin nitrate 1:20,000 (Privin) voluntary muscle activity of the orbicularis oculi muscle was recorded, and the area under the EMG curve was calculated for quantitative comparison of muscular activity between the groups. ⋯ In six additional patients, the topographic distribution of a mixture of metrizamide (Solutrast) and the anesthetic solution was evaluated radiographically to assess potential causes of differences in the effectiveness of the block techniques. Within 1 min after modified O'Brien block, the voluntary activity of the orbicularis oculi muscle and the force of lid closure were significantly, lower than those after both the modified van Lint and the Atkinson techniques: furthermore, a significant decrease in the voluntary lid movement was observed within 3 min. Whereas the modified O'Brien block nearly abolished voluntary muscle activity, force of lid closure and lid movement, there was only a minor decrease in the area under the EMG curve and in the force of lid closure after the modified van Lint and Atkinson blocks (about 20%).(ABSTRACT TRUNCATED AT 250 WORDS)