The Open Anesthesia Journal

Formerly: The Open Anesthesiology Journal

ISSN: 2589-6458 ― Volume 14, 2020

Effectiveness and Safety of Single Percutaneous Peribulbar Block Using Magnesium Sulphate as an Adjuvant to Local Anesthetics Versus the Standard Peribulbar Block for Strabismus Surgery in Adults

Norhan Aly Sherif1, *, Mayada Khairy Mohamad1, Sameh Galal Taher2, Ahmed Abdou Hannon2, Hesham Mohamed Salem1
1 Department of Anesthesia, Research Institute of Ophthalmology, Cairo, Egypt.
2 Department of Pediatric Ophthalmology and Strabismus, Research Institute of Ophthalmology, Cairo, Egypt.



Peribulbar anesthesia in ophthalmic surgeries is limited by delayed and/or incomplete orbital akinesia and inadequate operative and postoperative analgesia.


The aim of this study was to assess the safety and effectiveness of a single percutaneous peribulbar block technique with 100 mg magnesium sulphate added to the local anesthetics used compared with the standard peribulbar block technique in adult strabismus surgery.


A total of 54 consecutive patients undergoing strabismus surgery were included in the study. They were divided into two equal groups (27 patients each). In group I, 1 ml (100 mg/ml) magnesium sulphate added to a mixture of 2 ml lidocaine 2%, 2 ml bupivacaine 0.5% and 1 ml hyaluronidase (150 units/ml) was administered through a single percutaneous peribulbar injection with a short (1 inch) needle, while in group II, a mixture of 1 ml saline added to 2 ml lidocaine 2%, 2 ml bupivacaine 0.5% and 1 ml hyaluronidase (150 units/ml) was administered using the standard peribulbar block technique. The collected data included patient's baseline characteristics, perioperative and early postoperative outcomes and follow-up data.


The elapsed time before the onset of anesthesia and akinesia of the globe was significantly shorter in group I compared with group II (1.9 ± 0.7 vs. 3.9 ± 1.0 min, p < 0.001; 2.3 ± 0.7 vs. 4.4 ± 1.2 min, p < 0.001 respectively), and the duration of anesthesia was significantly longer in group I compared with group II (180.0 ± 0.0 vs. 43.0 ± 8.5 min, p < 0.001). The median VAS pain score was significantly lower in group I compared with group II (1.0 vs. 4.0, p < 0.001), and the patient's satisfaction was significantly higher in group I compared with group II (100.0% vs. 25.9%, p < 0.001).


Co-administration of 100 mg magnesium sulphate with the local anesthetics was effective and safe. It achieved suitable conditions to start surgery rapidly. Further, it improved the quality of operative conditions and patient satisfaction.

Keywords: Adult, Akinesia, Analgesia, Magnesium sulphate, Peribulbar block, Strabismus.

Article Information

Identifiers and Pagination:

Year: 2019
Volume: 13
First Page: 100
Last Page: 105
Publisher Id: TOATJ-13-100
DOI: 10.2174/2589645801913010100

Article History:

Received Date: 12/07/2019
Revision Received Date: 14/09/2019
Acceptance Date: 24/09/2019
Electronic publication date: 24/10/2019
Collection year: 2019

© 2019 Sherif et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: Address correspondence to this author at the Department of Anesthesia, Research Institute of Ophthalmology, Cairo, Egypt;

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