THE HYUGONI® APPROACH TO CONTINUOUS LOCOREGIONAL ANESTHESIA IN PENETRATING KERATOPLASTY: TECHNICAL DESCRIPTION AND CLINICAL OUTCOMES UNDER ULTRASOUND GUIDANCE

Autores

  • Hugo Camara Tinoco de Siqueira
  • Andrew Alves Marinho

DOI:

https://doi.org/10.36557/2674-9432.2026v5n3p3105-3118

Palavras-chave:

Peribulbar anesthesia, Penetrating keratoplasty, Ultrasound, Flexible cannula, Hyugoni.

Resumo

Background: Penetrating keratoplasty (PK) is a full-thickness corneal transplantation procedure that demands precise anesthetic management, particularly given the risk of intraocular pressure fluctuations in an open-globe setting. Objective: To describe a continuous peribulbar anesthetic technique using an ultrasound- guided flexible blunt cannula (Hyugoni®, 25G) and to evaluate its safety and effectiveness in patients undergoing penetrating keratoplasty. Methods: A retrospective case series was conducted involving 362 consecutive adult patients who underwent PK under continuous peribulbar block with mild sedation at a single ophthalmic center between December 2019 and December 2023. Results: The technique provided effective anesthesia with a mean total local anesthetic volume of 7.97 ± 4.1 mL. Supplemental intraoperative anesthetic was required in 58 patients (16.0%), and additional sedation in 42 patients (11.6%). No severe surgical complications were recorded.  Conclusion: Ultrasound-guided continuous peribulbar block with the Hyugoni® cannula demonstrated a favorable safety and effectiveness profile, enabling surgical anesthesia with low total anesthetic volumes and minimal rescue requirements.

Downloads

Não há dados estatísticos.

Referências

1. Salmon JF. Kanski’s Clinical Ophthalmology: A Systematic Approach. 9th ed. Edinburgh: Elsevier; 2019.

2. Mannan R, Sharma N, Pruthi A, Maharana PK, Vajpayee RB. Penetrating keratoplasty for perforated corneal ulcers under topical anesthesia. Cornea. 2013;32(11):1428–31.

3. Seitz B, El-Husseiny M, Langenbucher A, Szentmáry N. Prophylaxis and management of complications in penetrating keratoplasty. Ophthalmologe. 2013;110(7):605–13.

4. Arentsen JJ. Penetrating keratoplasty techniques. Int Ophthalmol Clin. 1988;28(1):14–23.

5. Chua A, Chua MJ, Kam P. Recent advances and anaesthetic considerations in corneal transplantation. Anaesth Intensive Care. 2018;46(2):162–70.

6. Guerrier G, Boutboul D, Rondet S, Hallal D, Levy J, Sjögren L, et al. Comparison of a supraglottic gel device and an endotracheal tube in keratoplasty performed under general anesthesia: a randomized clinical trial. Cornea. 2016;35(1):37–40.

7. TY Care Indústria e Comércio Ltda. Cânula Hyugoni [notificação de dispositivo médico classe II]. Diário Oficial da União, Seção 1, nº 60. Brasília: ANVISA; 2026 Mar 30. Processo nº 25351.052438/2026-61. Notificação nº 0284356263.

8. Yeung SN, Kim P, Lichtinger A, Amiran MD, Hollands S, Teitel S, et al. Combined topical and intracameral anesthesia for Descemet’s stripping automated endothelial keratoplasty. Int Ophthalmol. 2012;32(3):273–6.

9. Fang JP, Hamill MB. Descemet’s stripping endothelial keratoplasty under topical anesthesia. J Cataract Refract Surg. 2007;33(2):187–8.

10. Kamoun B, Kharrat W, Khlif H, Chaabouni S, Maazoun M, Feki J. Retrobulbar anesthesia during keratoplasty. Tunis Med. 2006;84(2):88–91.

11. Cheng AC, Rao SK, Lam DS. Penetrating keratoplasty using topical anesthesia. Cornea. 2005;24(6):766.

12. Steinemann TL, Sheikholeslami RR, Klein EF, Prokopius MJ. Short-acting peribulbar anesthesia with 2-chloroprocaine. J Cataract Refract Surg. 2002;28(1):195–6.

13. Muraine M, Calenda E, Watt L, Proust N, Cardon A, Eupherte L, et al. Peribulbar anaesthesia during keratoplasty: a prospective study of 100 cases. Br J Ophthalmol. 1999;83(1):104–9.

14. Meur G, Meur-Terfve L. Peri-ocular anesthesia by unique caruncular injection in surgery of the anterior segment. Bull Soc Belge Ophtalmol. 1998;268:111–3.

15. Fry RA. Innovation in anaesthesia for keratoplasty. Anaesth Intensive Care. 1998;26(5):595–6.

16. Yavitz EQ. Topical and intracameral anesthesia for corneal transplants. J Cataract Refract Surg. 1997;23(10):1435.

17. Boskovski NA, Bormes P, Landers DF. Anesthetic management for the high-risk ophthalmic patient. J Clin Anesth. 1992;4(1):39–41.

18. Starkman M, Belotte F, Venutolo F, Levêque P, Lesouef JM, Marsepoil T. Anesthesia for keratoplasty. Cah Anesthesiol. 1986;34(3):221–5.

19. Smith RB, Linn JG Jr. Retrobulbar injection of bupivacaine (marcaine) for anesthesia and akinesia. Invest Ophthalmol. 1974;13(2):157–8.

20. Verner IR. General anaesthesia for ophthalmic surgery? Proc R Soc Med. 1967;60(12):1280–2.

21. Salleras A. General curare akinesia in corneal transplantation and cataract: with comments on the use of artificial hibernation in ophthalmology. Dia Med. 1953;25(90):2505–10.

22. Nissman SA, Pasternak JF. Delayed-onset expulsive choroidal hemorrhage attributed to an acute elevation in systemic blood pressure following traumatic globe rupture. Ophthalmic Surg Lasers Imaging. 2005;36(4):340–2.

23. Collie DM. Outpatient penetrating keratoplasty. Aust N Z J Ophthalmol. 1989;17(4):373–7.

24. Aquavella JV, John T, Garcia E, Rao GN. Outpatient keratoplasty. Am J Ophthalmol. 1985;100(2):276–80.

25. Siqueira H, De Siqueira C, De Lima M, Lins L. Ultrasound-guided peribulbar block with blunt cannula for cataract surgery: a review of historical case-series. Open J Ophthalmol. 2022;12:322–34.

26. Siqueira HCT. [Título do modelo de utilidade]. Instituto Nacional da Propriedade Industrial. Revista da Propriedade Industrial nº 2831. Brasil: INPI; 2025 Apr 8. Pedido nº BR 20 2023 019550-0.

Downloads

Publicado

2026-05-30

Como Citar

SIQUEIRA, Hugo Camara Tinoco de; MARINHO , Andrew Alves. THE HYUGONI® APPROACH TO CONTINUOUS LOCOREGIONAL ANESTHESIA IN PENETRATING KERATOPLASTY: TECHNICAL DESCRIPTION AND CLINICAL OUTCOMES UNDER ULTRASOUND GUIDANCE . Periódicos Brasil. Pesquisa Científica, Macapá, Brasil, v. 5, n. 3, p. 3105–3118, 2026. DOI: 10.36557/2674-9432.2026v5n3p3105-3118. Disponível em: https://periodicosbrasil.emnuvens.com.br/revista/article/view/1146. Acesso em: 30 maio. 2026.

Edição

v. 5 n. 3 (2026): Periódicos Brasil. Pesquisa Científica - QUALIS A3

Seção

Ciências da Saúde

Licença

Copyright (c) 2026 Hugo Camara Tinoco de Siqueira, Andrew Alves Marinho

Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.

Você tem o direito de:

  1. Compartilhar — copiar e redistribuir o material em qualquer suporte ou formato para qualquer fim, mesmo que comercial.
  2. Adaptar — remixar, transformar, e criar a partir do material para qualquer fim, mesmo que comercial.
  3. O licenciante não pode revogar estes direitos desde que você respeite os termos da licença.  

 

De acordo com os termos seguintes:

  1. Atribuição — Você deve dar o crédito apropriado , prover um link para a licença e indicar se mudanças foram feitas . Você deve fazê-lo em qualquer circunstância razoável, mas de nenhuma maneira que sugira que o licenciante apoia você ou o seu uso.
  2. Sem restrições adicionais — Você não pode aplicar termos jurídicos ou medidas de caráter tecnológico que restrinjam legalmente outros de fazerem algo que a licença permita.