Effect of adding clonidine to lidocaine on ocular hemodynamics during sub-Tenon’s anesthesia: randomized double-blind study

• Published in: Brazilian journal of anesthesiology (Elsevier) Vol. 71; no. 6; pp. 628 - 634
• Main Authors: Cabral, Sigmar Aurea, Carraretto, Antonio Roberto, Sousa, Angela Maria, Gomez, Renato Santiago
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier Editora Ltda 01.11.2021; Elsevier
• Subjects: Anesthesia, Local; Anesthetics, Local; Cataract surgery; Clinical Research; Clonidine; Double-Blind Method; Hemodynamics; Humans; Intraocular pressure; Lidocaine; Ocular perfusion pressure; Ocular pulse amplitude; Sub-Tenon’s anesthesia; Sub-Tenon’s anesthesia; Cataract surgery; Clonidine; Ocular pulse amplitude; Ocular perfusion pressure; Intraocular pressure
• ISSN: 0104-0014; 0104-0014
• DOI: 10.1016/j.bjane.2021.08.004

Different regional anesthesia techniques for ophthalmology can have hemodynamic effects on the eye. We assessed the effects of adding clonidine to lidocaine on Intraocular Pressure (IOP), Ocular Pulse Amplitude (OPA), and Ocular Perfusion Pressure (OPP) after the sub-Tenon’s technique for cataract surgery. The study included 40 patients randomly allocated into two groups: sub-Tenon’s blockade with Lidocaine plus Saline Solution (LS) or Lidocaine plus Clonidine (LC). IOP, OPA and OPP were measured before anesthesia, and 1, 5 and 10 minutes after the injection of anesthetic solution. There was no difference between the groups in IOP, OPA, and OPP baseline values. After the injection of the anesthetic solution, the IOP increased in both groups at minute one, with a mean difference of +4.67 mmHg (p = 0.001) and +2.15 mmHg (p = 0.013) at 5 minutes. The increase was lower in the LC group when compared to LS (p = 0.027). OPA decreased in both groups, with a baseline difference, after 1 minute, of -0.85 mmHg (p =  -0.85 mmHg (p = 0.001), and at 5 and 10 minutes with differences of -1.17 (p = 0.001) and -0.89 mmHg (p = 0.001), respectively. The highest decrease was observed in group LC in relation to group LS (p = 0.03). There was no difference in OPP in relation to baseline measurements. Adding clonidine to lidocaine for sub-Tenon’s anesthesia reduced IOP and OPA without significant changes in OPP.