Dexmedetomidine: a revolution in anesthesia for strabismus surgery

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.