title: Efficacy of varying concentrations of hyaluronidase in peribulbar anaesthesia.
abstract: We have compared the efficacy of adding varying concentrations of hyaluronidase to a standard mixture of 2% lidocaine and 1% ropivacaine to provide peribulbar anaesthesia for cataract surgery. We used (i) the time to adequate anaesthesia for surgery and (ii) ocular and eyelid movement scores at 8 min after block as clinical endpoints. Ninety patients were randomly allocated to receive 7-10 ml of equal volumes of 2% lidocaine and 1% ropivacaine without hyaluronidase or with hyaluronidase 15 IU ml(-1) or 150 IU ml(-1). Median time at which the block was adequate for surgery was 6 min in all groups (interquartile range 4-12 min). Median eyelid movement scores were similar in all groups, but the ocular movement scores at 8 min were significantly lower in the group which received hyaluronidase 150 IU ml(-1) than in the group not given hyaluronidase (P<0.03). There were no differences between groups in the incidence of minor complications. A high concentration of hyaluronidase resulted in a statistically significantly lower ocular movement score at 8 min; the clinical relevance of this finding is uncertain.
authors.affiliation: Department of Anaesthesia, Bromley Hospital, Kent, UK.
authors.forename: C
authors.initials: C
authors.lastname: Mantovani
authors.forename: A E
authors.initials: AE
authors.lastname: Bryant
authors.forename: G
authors.initials: G
authors.lastname: Nicholson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000577:Amides; D000776:Anesthesiology; D019162:Anesthetics, Combined; D002387:Cataract Extraction; D002983:Clinical Competence; D004334:Drug Administration Schedule; D005133:Eye Movements / Q000187:drug effects; D005260:Female; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage*; D007267:Injections; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009915:Orbit; D000077212:Ropivacaine; D016896:Treatment Outcome
chemical_list: D000577:Amides; D019162:Anesthetics, Combined; D000077212:Ropivacaine; D008012:Lidocaine; D006821:Hyaluronoglucosaminidase