Comparison of Magnesium Sulfate Versus Hyaluronidase as Adjuvants in Peribulbar Anaesthesia for Cataract Surgery at National Eye Centre, Kaduna, North-West Nigeria: Being the text of the Council Lecture delivered during the 46th Annual Scientific Conference of the Ophthalmological Society of Nigeria on 1st September, 2022

Abdulrazak MomohJimoh; Emmanuel O. Babalola; Mahmoud B. Alhassan; Aminatu A. Abdulrahman; Murtala M. Umar; Lukman A. Raji; Ugochukwu A. Eze

Authors

Abdulrazak MomohJimoh Department of Ophthalmology, Federal Medical Centre, Keffi, Nigeria;
Emmanuel O. Babalola Department of Ophthalmology, Rachel Eye Centre, Abuja, Nigeria
Mahmoud B. Alhassan National Eye Centre, Kaduna, Nigeria
Aminatu A. Abdulrahman National Eye Centre, Kaduna, Nigeria
Murtala M. Umar National Eye Centre, Kaduna, Nigeria
Lukman A. Raji National Eye Centre, Kaduna, Nigeria
Ugochukwu A. Eze Department of Ophthalmology, Federal Medical Centre, Asaba, Nigeria

Keywords:

anaesthesia, peribulbar, hyaluronidase, Magnesium sulfate, Cataract

Abstract

Background: Akinesia and analgesia are important for successful ophthalmic surgery. The efficacy of local anaesthesia can be enhanced by the use of adjuvants such as Hyaluronidase and Magnesium sulfate. Magnesium sulfate is readily available and has a long shelf life, while Hyaluronidase which is more commonly used has some associated drawbacks such as the risk of anaphylaxis, short shelf-life and not being readily available in some parts of Nigeria.

Aim: To compare the effects of Magnesium sulfate versus Hyaluronidase as adjuvants in Peribulbar anaesthesia for cataract surgery.

Methods: A randomized, controlled, double-blinded experimental study involving 150 patients with age-related cataract surgery was carried out between October and December 2020. They were randomly allocated into three groups of fifty (50) subjects each. All the patients received a peribulbar local anaesthetic (LA) injection. Magnesium sulfate group had an additional 80mg of MgSO 4 in 0.5mls of normal saline (N/S). Hyaluronidase group had an additional 15.0 IU of hyaluronidase while the control group had an addition of 0.5mls of plain normal saline. Ocular akinesia score, duration of globe akinesia, and postoperative pain score were assessed.

Result: There was an earlier onset and longer duration of akinesia among the magnesium sulfate group compared to other groups (p <0.001). There was no significant difference in the postoperative pain scores across the groups (p > 0.850).

Conclusion: These findings suggest that there is better akinesia and prolonged duration of peribulbar block with adjuvant magnesium sulfate.

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