Comparison of a bupivacaine 0.5% and lidocaine 2% mixture with levobupivacaine 0.75% and ropivacaine 1% in peribulbar anaesthesia for cataract surgery with phacoemulsification.
OBJECTIVE
To compare a bupivacaine and lidocaine mixture with levobupivacaine and ropivacaine in terms of safety, efficacy and blocking quality in peribulbar anaesthesia for phacoemulsification.


METHODS
A total of 105 patients scheduled for cataract surgery with peribulbar anaesthesia were randomly allocated into three groups of 35 patients each, to receive 5 ml of, respectively, a 1 : 1 mixture of bupivacaine 0.5% and lidocaine 2% (group 1), levobupivacaine 0.75% (group 2), or ropivacaine 1% (group 3). Ocular movement scores were evaluated at 2, 4, 6, 8 and 10 mins after injection. Intraoperative and postoperative analgesia were evaluated by verbal pain scores. Duration of surgery, need for supplementary anaesthesia, haemodynamic parameters and the incidence of perioperative complications were recorded.


RESULTS
The ocular movement score in min 2 was significantly lower in group 1. There was no significant difference between groups 2 and 3. Ocular movement scores at mins 4 and 6 were significantly decreased in group 1 and 2 compared with group 3. There was no significant difference among the groups in ocular movement scores at mins 8 and 10. Verbal pain scores in postoperative hour 4 were highest in group 3, but scores for the intraoperative period and postoperative hours 1 and 2 were similar among the groups. Duration of surgery and haemodynamic parameters did not differ among the groups.


CONCLUSIONS
All agents were considered to be convenient for clinical use in cataract surgery with peribulbar anaesthesia. Although the ocular movement scores in the ropivacaine group were higher than in the other groups at mins 4 and 6, this did not imply any clinical significance.
Department of Ophthalmology, Baskent University School of Medicine, Ankara, Turkey. borazan74@hotmail.com
Mehmet
M
Borazan
Aylin
A
Karalezli
Sibel
S
Oto
Cengiz
C
Algan
Yonca
Y
Aydin Akova
D000368:Aged; D000577:Amides / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000031:analogs & derivatives / Q000627:therapeutic use*; D002387:Cataract Extraction / Q000379:methods*; D004338:Drug Combinations; D005133:Eye Movements / Q000187:drug effects; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D000077212:Ropivacaine; D013997:Time Factors; D016896:Treatment Outcome
D000577:Amides; D000779:Anesthetics, Local; D004338:Drug Combinations; D000077212:Ropivacaine; D008012:Lidocaine; D000077554:Levobupivacaine; D002045:Bupivacaine