title: Adjunctive Local Application of Lidocaine during Scleral Buckling under General Anesthesia.
abstract: OBJECTIVE
  To evaluate the effect of local lidocaine application on the incidence of the oculocardiac reflex (OCR) during scleral buckling (SB) for rhegmatogenous retinal detachment (RRD) under general anesthesia.
  
  
  METHODS
  In a randomized clinical trial, eyes with RRD scheduled for SB under general anesthesia were randomized to adjunctive local application of 1 ml lidocaine 2% versus normal saline to the muscles after conjunctival opening. Surgical stimulation was initiated 5 minutes afterwards. Additionally, 100 mg of lidocaine 2% was added to 50 ml of normal saline in the treatment group which was used for irrigation during surgery; control eyes were irrigated with normal saline. The incidence of the OCR, rate of postoperative nausea/vomiting (PONV), total intravenous (IV) analgesic dose, duration of surgery, and period of hospitalization were compared between the study groups.
  
  
  RESULTS
  Thirty eyes of 30 patients including 22 (73.3%) male and 8 (26.7%) subjects with mean age of 49.4±16.3 years were operated. OCR and PONV occurred less frequently, and total intravenous analgesic dose was significantly lower in the lidocaine group (P < 0.05 for all comparisons). However, no significant difference was noted between the study groups in terms of duration of surgery and period of hospitalization.
  
  
  CONCLUSIONS
  Adjunctive local application of lidocaine during SB under GA for RRD decreases the rate of OCR and PONV, reduces the intravenous analgesic dose, but does not affect the duration of surgery or hospitalization.
authors.affiliation: Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Dehghani
authors.forename: Kamran
authors.initials: K
authors.lastname: Montazeri
authors.forename: Amin
authors.initials: A
authors.lastname: Masjedi
authors.forename: Najmeh
authors.initials: N
authors.lastname: Karbasi
authors.forename: Leila
authors.initials: L
authors.lastname: Ashrafi
authors.forename: Behrooz
authors.initials: B
authors.lastname: Saeedian