Strabismus surgery is crucial for correcting
eye alignment and restoring binocular vision. It requires effective anesthesia
to minimize pain and optimize outcomes. Among recent innovations,
dexmedetomidine, an alpha-2 receptor agonist, stands out as a promising adjunct
to local anesthetics. But what is the best route of administration—intravenous
or peribulbar? This article examines the advantages of these two approaches.
What is the best route of administration for Dexmedetomidine?
In this study, 46 adult patients undergoing strabismus surgery were selected
and divided into two groups:
- Intravenous: Administration of 50 µg of
dexmedetomidine via infusion, followed by a standard peribulbar block.
- Peribulbar: Addition of 50 µg of dexmedetomidine
directly to the local anesthetic mixture.
The study first demonstrated that the
peribulbar route provided 3.2 hours of longer postoperative analgesia compared
to the intravenous route. Similarly, a significantly longer duration of
motor block was observed in the peribulbar group. Regarding operating time,
the intravenous administration allowed for shorter surgeries. Finally,
patient and surgeon satisfaction scores were higher in the peribulbar group.
Dexmedetomidine: new horizons in surgical
anesthesia
This study demonstrates that peribulbar dexmedetomidine offers superior
benefits in terms of patient comfort and effectiveness. However, intravenous
administration remains a viable alternative for faster procedures due to
enhanced sedation. Multicenter studies with larger sample sizes are now
needed to confirm these results, refine anesthesia protocols, and explore
potential applications of dexmedetomidine in other surgical contexts requiring
regional blocks.
