Method for prolonging anterior chamber anaesthesia and pupil dilatation experimentally

FIELD: medicine.

SUBSTANCE: anterior chamber anaesthesia and pupil dilatation accompanying anterior eye segment surgeries experimentally involve a preoperative administration of a composition in an amount of 0.1-0.2 ml representing 0.005% 1-(3-pyrrolidinopropyl)-2-phenylimidazo[1,2-a]benzimidazole dihydrochloride into the anterior eye segment. The composition is prepared in 1% viscoelastic solution, visiton PEG.

EFFECT: prolonging anaesthetic effect and pupil dilatation with no mydriatics used.

2 ex

 

The present invention relates to experimental medicine, namely to pharmacology and ophthalmology, and can be further used for prolonging prednamerennoe anesthesia and pupil dilation operations on the anterior segment of the eye.

While used in cataract surgery block anesthesia (Sultanova, retro and parabulbar) in combination with athralgia potential risk of numerous complications: the formation of retro and parabulbar hematoma, orbital infection, perforation of the sclera capsules eyeball sharp injection needle, the needle trauma to the optic nerve, increased intraocular pressure due to the additional volume injected anesthetic, occlusion of the Central retinal artery, persistent postoperative mydriasis, ptosis, postoperative diplopia and so on [Anisimov, S. Y., Anisimov, S. I., Colander Y. P. Effectiveness of epibulbar anesthesia in outpatient cataract surgery and glaucoma // Modern technologies in cataract surgery: Sat. scient. Tr. - M., 2002. - S. 21-28; Bakunin N. A., Ivanov, I. L. Rational method of local anesthesia in ophthalmology // VIII the age of three. scientific and practical use. proc. from INTL. participation "Fedorovskii readings - 2009": Sa. scient. articles / FGI "IRTC "eye microsurgery". - M., 2009. - S. 322-323].

Execution block anesthesia causes of the patient, except for b is Li, fear, psychological discomfort, unexpected vegetative reactions [Bakunin N. A., Ivanov, I. L. Rational method of local anesthesia in ophthalmology // VIII the age of three. scientific and practical use. proc. from INTL. participation "Fedorovskii readings - 2009": Sa. scient. articles / FGI "IRTC "eye microsurgery". - M., 2009. - S. 322-323; Kaganova L. O., Jaber N.A., Chuguev M. C., kuniji B. M., Romanenko B. C. advantages of injection-free anesthesia in the outpatient ophthalmic surgery // Modern technologies in cataract surgery: Sat. scient. Tr. - M., 2002. - S. 155-161]. In recent years, in ophthalmic surgery are increasingly being used in chamber anesthesia [Canavan K. S., A. Dark, Garrioch MA. Sub-Tenon's administration of local anaesthetic: a review of the technigue // Br. J. Anaesth. - 2003. - Vol.17. - P. 1003-1107; Lo Martire N., Savastano, S., L. Rossini et al. Topical anaesthesia for cataract surgery with photoemulsification: lidocain 2% versus ropivacaine 1%: preliminary results // Minerva Anaesthesiol. - 2002. - Vol.68. - P. 529-535.]. The only local anesthetic that is allowed to be used in the internal chamber of the anesthetic is lidocaine. Based on this research in the mentioned direction have important theoretical and practical value.

Well-known local anesthetic for prednamerennoe anesthesia for surgical intervention associated with cataract extraction and intraocular lens implantation (Koch P. S. Anterior chamber irrigation with unpreserved 1% lidocaine for anesthesia during cataract surgery. J. Cataract Refractive Syrg 1997; 23, 551-554). what about the time of the operation in the anterior chamber of the eye injected with 1% aqueous solution of lidocaine in the amount of 0.25-0.5 ml

Known composition of local anaesthetics isocaine with visitanos-PEG used for surface anesthesia [Galenko-Yaroshevsky P. A., Lisitsyn N. P., Takhchidi H. P. Activity of combinations of isocaine with visitanos-PEG under conditions of anesthesia surface method // Kuban scientific medical Bulletin, KSMU, 2009, №2. - S. 66-69].

The closest analogue adopted patent No. 2147876 (Fedorov, S. N.; Malyugin B. E.; Bagrov, S. N.; Maklakov, I. A.; Wersin A. A., 2000), according to which the pharmaceutical composition for the treatment of pain in various types of ophthalmic surgeries and procedures, including local anestis, further comprises viscoelastic and heparin in the following ratio, wt.%: a local anesthetic is 0.01 to 4.0; heparin - 5-500 units/ml; viscoelastic rest. May be injected into the anterior chamber of the eye, and is applied to its surface.

The disadvantage of the application of local anesthetics as proposed is that with the passage of a significant amount of irrigation solution through the camera eye, during such operation stages, as hydrodissection, aspiration and irrigation during the leaching lenticular masses, anesthetics rapidly washed away from the anterior chamber of the eye, the patient begins to feel pain, a narrowing of the pupil, which requires re-introduction of anesthetic. In addition, the probability is proniknoveniya aqueous solution of anesthetic to the posterior segment of the eye and the toxic effect on the optic nerve and retina. According closest analogue (patent No. 2147876) in the composition is included heparin, which may cause the occurrence of bleeding in case of accidental trauma to the iris.

The task of the invention is to achieve a deep and prolonged anaesthesia and dilatation of the pupil without the use of Mydriatics throughout surgery on the anterior segment of the eye, as well as the elimination of pain up to 2 hours in the postoperative period. The method is tested on rabbits.

The essence of the invention is that immediately before the beginning of the operation in front of the camera and impose 0.1-0.2 ml pre-seasoned during the day song 0.005% solution of dihydrochloride of 1-(3-pyrrolidinyl)-2-phenylimidazo[1,2-a]benzimidazole, prepared on viscoelastic - visitone-PEG.

The technical result of the application of the proposed method is the increase of time (up to two hours) anesthetic effect and pupil dilation achieved with a single introduction of the proposed composition in the anterior chamber of the eye, allowing for use in medicine to increase the comfort level of both patient of the surgeon during surgery, and to provide analgesia in the postoperative period up to 2 hours.

The advantage of the inventive method is that achieved Bo is significant for the depth and duration of analgesic effect during surgery on the anterior segment of the eye, and in the postoperative period, as well as pupil dilation without using Mydriatics; reducing toxic effects of anesthetic to the eye tissue. Used as a solvent anesthetic agent viscoelastic - vision-PEG protects the corneal endothelium during surgical manipulation.

The proposed pharmaceutical composition for the treatment of pain and pupil dilation when cell anesthesia of the eye can be further used when conducting eye surgery (cataract extraction with intraocular lens implantation, removal of intraocular foreign body, vitrectomy, penetrating keratoplasty, and others). After surgical intervention, the pharmaceutical composition should clean up the irrigation solution.

The method is tested in experiments at 160 eyes 80 rabbits, including 40 of the eye, the cornea which were subjected to transmission electron microscopy, which was objective evidence of safety and advantages of this method over existing.

Example 1. Experiment. Rabbit weighing 3 kg in the right eye through the paracentesis put 0.1 ml of the proposed composition, which led to full anaesthesia and dilatation of the pupil. Anesthesia was checked by algesimeter every 5 minutes Full anesthesia lasted more than 2 hours. The pupil remained wide for 1.5 the Asa. After anesthesia of the cornea was autocaravana and investigated using transmission electron microscopy. The study found that the ultrastructure of all layers of the cornea without significant morphological changes.

Example 2. Experiment. Rabbit weighing 4 kg in the left eye through the paracentesis introduced 0.2 ml of the proposed composition, which led to full anaesthesia and dilatation of the pupil. Anesthesia was checked by algesimeter every 5 minutes Full anesthesia lasted more than 2 hours. The pupil remained wide for 1.5 hours. After anesthesia of the cornea was autocaravana and investigated using transmission electron microscopy. The study found that the ultrastructure of all layers of the cornea without significant morphological changes.

The way prolonged prednamerennoe anesthesia and expansion of the pupil of the eye in the experiment, characterized in that the front chamber and injected with 0.1-0.2 ml of the composition, representing 0.005% solution of dihydrochloride of 1-(3-pyrrolidinyl)-2-phenylimidazo[1,2-a]benzimidazole, prepared with 1% solution viscoelastic - visiona-PEG.



 

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FIELD: veterinary medicine.

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1 tbl

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1 dwg, 1 ex

FIELD: biotechnology.

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2 dwg, 2 ex

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7 dwg, 1 ex

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2 dwg, 2 ex

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3 dwg, 40 tbl

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1 ex

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1 tbl

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24 cl, 4 tbl

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10 cl, 1 dwg, 2 tbl, 1 ex

FIELD: medicine, pharmaceutics.

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13 cl, 1 ex

FIELD: medicine.

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5 tbl, 3 ex

FIELD: medicine.

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EFFECT: using the invention provides the partial restoration of the morphological structure and functional adequacy of the retina involved into the developing fibrovascular tissue.

1 ex

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