Peribulbar anaesthesia with 1% ropivacaine and hyaluronidase 300 IU ml-1: comparison with 0.5% bupivacaine/2% lidocaine and hyaluronidase 50 IU ml-1.
The low toxicity of ropivacaine makes it attractive for peribulbar anaesthesia. However, its motor-sparing properties are undesirable when akinesia is important. Hyaluronidase (300 IU ml-1) promotes the onset and quality of peribulbar blockade when used with other agents. We investigated the onset and quality of ocular akinesia in 80 patients randomized to receive 1% ropivacaine plus hyaluronidase 300 IU ml-1 (group 1), or bupivacaine 0.5%/Lidocaine 2% plus 50 IU ml-1 hyaluronidase (group 2). Ocular akinesia was scored from 0 (no movement) to 8 (full movement) every 2 min for 20 min. The groups showed no difference in the rate of onset or degree of akinesia achieved (analysis of variance with repeated measures; P = 0.34). Sixty per cent of patients in group 1 and 55% in group 2 achieved akinesia scores of < or = 4 by 6 min (chi 2 test; P = 0.5). We conclude that both peribulbar solutions produce equivalent onset and quality of ocular akinesia.
Woodward
D K
DK
Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China.
Leung
A T
AT
Tse
M W
MW
Law
R W
RW
Lam
D S
DS
Ngan Kee
W D
WD
D000368:Aged; D000577:Amides / Q000494:pharmacology*; D000772:Anesthesia, Local / Q000379:methods; D019162:Anesthetics, Combined / Q000494:pharmacology; D000779:Anesthetics, Local / Q000494:pharmacology*; D002045:Bupivacaine / Q000494:pharmacology; D004311:Double-Blind Method; D005133:Eye Movements / Q000187:drug effects*; D005260:Female; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000494:pharmacology*; D008012:Lidocaine / Q000494:pharmacology; D008297:Male; D018918:Phacoemulsification; D000077212:Ropivacaine
D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine; D006821:Hyaluronoglucosaminidase; D002045:Bupivacaine