Articaine versus lidocaine plus bupivacaine for peribulbar anaesthesia in cataract surgery.
BACKGROUND
We compared the efficacy and safety of articaine 2% with a mixture of lidocaine 2% and bupivacaine 0.5% without hyaluronidase for peribulbar anaesthesia in cataract surgery.


METHODS
In this double-blind randomized clinical study, 58 cataract patients were allocated to receive either articaine 2% with epinephrine 1:200 000 or a mixture of equal parts of lidocaine 2% with epinephrine 1.25:100 000 and bupivacaine 0.5%. Ocular and eyelid movement scores, the number of supplementary injections, total volume of solution used and pain and complications during injection and surgery were used as clinical end-points.


RESULTS
Articaine produced greater akinesia after 5 min (P=0.03). Eighteen patients (60%) in the articaine group and 26 (93%) in the lidocaine/bupivacaine group required a second injection (P=0.003). A third injection was needed by two patients (7%) in the articaine group and 12 (43%) in the lidocaine/bupivacaine group (P=0.001). The total mean volume of local anaesthetic required to achieve akinesia was mean 9.4 (SD 1.7) ml in the articaine group and 11.28 (1.86) ml in the lidocaine/bupivacaine group (P<0.001). Median pain score was lower in the articaine group than in lidocaine/bupivacaine group during injection (P=0.004) and surgery (P=0.014). There was no difference between the groups for the incidence of complications.


CONCLUSIONS
Articaine 2% without hyaluronidase is more advantageous than a mixture of lidocaine 2% and bupivacaine 0.5% without hyaluronidase for peribulbar anaesthesia in cataract surgery.
Ozdemir
M
M
Department of Ophthalmology, Medical Faculty of Kahramanmaras Sutcu Imam University, T-46050 Kahramanmaras, Turkey. drmozdemir@hotmail.com
Ozdemir
G
G
Zencirci
B
B
Oksuz
H
H
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D002045:Bupivacaine; D002355:Carticaine; D002387:Cataract Extraction; D004311:Double-Blind Method; D005133:Eye Movements / Q000187:drug effects; D005143:Eyelids / Q000187:drug effects; D006801:Humans; D006821:Hyaluronoglucosaminidase; D008012:Lidocaine; D008875:Middle Aged
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D008012:Lidocaine; D002355:Carticaine; D006821:Hyaluronoglucosaminidase; D002045:Bupivacaine