Comparison of 1% ropivacaine with 0.75% bupivacaine and 2% lidocaine for peribulbar anaesthesia.
We have compared the efficacy of 1% ropivacaine with a mixture of 0.75% bupivacaine and 2% lidocaine for peribulbar anaesthesia in cataract surgery. We used the time to adequate block for surgery, and ocular and eyelid movement scores at 8 min after block as clinical end-points. Ninety patients were allocated randomly to receive 7-10 ml of a mixture of equal parts of 0.75% bupivacaine and 2% lidocaine or an equal volume of 1% ropivacaine alone. Hyaluronidase 15 iu ml-1 was added to both solutions. There were no differences between groups in clinical end-points. Median time at which the block was adequate to start surgery was 8 min (interquartile range 4-10 min) in each group. Median eyelid movement scores were similar in both groups, but the bupivacaine and lidocaine mixture produced a significantly decreased ocular movement score at 2, 4 and 6 min (P < 0.05). There was no difference between groups in the incidence of minor complications. Based on clinical end-points, time to adequate block for surgery and median ocular and eyelid movement scores at 8 min, 1% ropivacaine as the sole agent for peribulbar anaesthesia was comparable with a mixture of 0.75% bupivacaine and 2% lidocaine.
Nicholson
G
G
Department of Anaesthesia and Intensive Care Medicine, St George's Hospital Medical School, London, UK.
Sutton
B
B
Hall
G M
GM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine; D002387:Cataract Extraction; D005133:Eye Movements / Q000187:drug effects; D005143:Eyelids / Q000187:drug effects; D005260:Female; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D000077212:Ropivacaine
D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine; D002045:Bupivacaine