The efficacy of 0.75% bupivacaine with pH adjustment and hyaluronidase for peribulbar blockade: the incidence of prolonged ptosis.
A prospective, double masked, randomised study was performed to compare the speed of onset of peribulbar anaesthesia using pH adjusted 0.75% bupivacaine, with and without the addition of hyaluronidase. No significant difference in speed of onset occurred due to the addition of hyaluronidase. There were 7 cases of post operative ptosis in the study group, including 1 case of orbital apex syndrome and 2 cases of transient 3rd nerve palsy. This incidence of post operative ptosis using pH adjusted 0.75% bupivacaine was statistically significantly greater than in a matched control group who received a 50:50 mixture of 1% lignocaine and 0.5% bupivacaine with hyaluronidase (p < 0.05). The possible causes of this increased incidence of post operative ptosis are discussed.
Sir Humphry Davy Anaesthetic Department, Bristol Royal Infirmary, U.K.
C
C
Mather
J H
JH
Smith
P A
PA
Bloom
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods; D001340:Autonomic Nerve Block; D001763:Blepharoptosis / Q000139:chemically induced*; D002045:Bupivacaine / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000009:adverse effects*; D006863:Hydrogen-Ion Concentration; D015994:Incidence; D007267:Injections; D008297:Male; D009883:Ophthalmic Solutions; D009915:Orbit; D011446:Prospective Studies
D009883:Ophthalmic Solutions; D006821:Hyaluronoglucosaminidase; D002045:Bupivacaine