Ropivacaine-lidocaine versus bupivacaine-lidocaine for retrobulbar anesthesia in cataract surgery.
OBJECTIVE
To compare the efficacy of ropivacaine mixed with lidocaine and bupivacaine mixed with lidocaine for retrobulbar anesthesia in cataract surgery.


METHODS
Philippine General Hospital, Manila, Philippines.


METHODS
This prospective double-masked study consisted of 80 patients randomized to receive ropivacaine 1%-lidocaine 2% (Group 1) or bupivacaine 0.5%-lidocaine 2% (Group 2) for retrobulbar anesthesia during extracapsular cataract extraction (ECCE). The main outcome measures were frequency of eye pain and amount of globe movement. The degree of pain was scored from 0 to 10 using a visual analog scale. Globe movement in 4 directions of gaze was measured with a ruler.


RESULTS
The number of patients with visual analog system scores greater than zero at 5 minutes after infiltration, 10 minutes after infiltration, intraoperatively, and 1, 2, and 4 hours postoperatively was 0, 0, 0, 1, 18, and 29, respectively, in Group 1 and 1, 1, 0, 1, 21, and 33, respectively, in Group 2. The mean globe movement at 5 minutes, 10 minutes after infiltration, and intraoperatively was 5.1 mm, 3.0 mm, and 0.6 mm, respectively, in Group 1 and 4.9 mm, 3.0 mm, and 0.3 mm, respectively, in Group 2. There were no significant differences in frequency of pain and amount of globe movement between the 2 groups at any time. No adverse reactions developed in either group. The duration of surgery was similar between groups.


CONCLUSIONS
Ropivacaine mixed with lidocaine and bupivacaine mixed with lidocaine were equally effective in producing ocular analgesia and akinesia for ECCE.
Uy
Harvey S
HS
University of the Philippines, Philippine General Hospital, Ermita, Manila, Philippines.
de Jesus
Arnel A
AA
Paray
Alvin A
AA
Flores
John D G
JD
Felizar
Loreto B
LB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D002387:Cataract Extraction; D004311:Double-Blind Method; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade / Q000379:methods; D009915:Orbit; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D011446:Prospective Studies; D000077212:Ropivacaine
D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine; D002045:Bupivacaine