Comparative clinical trial of topical anaesthetic agents for cataract surgery with phacoemulsification: lidocaine 2% drops, levobupivacaine 0.75% drops, and ropivacaine 1% drops.
OBJECTIVE
To assess the safety and efficacy of topical lidocaine, levobupivacaine, and ropivacaine in cataract surgery with phacoemulsification.


METHODS
One hundred and five patients scheduled for cataract surgery with topical anaesthesia were randomly allocated into 3 groups of 35 patients each to receive eye drops of lidocaine 2%, levobupivacaine 0.75%, or ropivacaine 1% every 5 min starting 30 min before surgery. Patients graded their pain using a 0-10-point verbal pain score (VPS) at different stages of the procedure. The levels of patient and surgeon satisfaction, the duration of surgery, complications, and the need for supplemental anaesthesia were recorded.


RESULTS
There was no significant difference in duration of surgery and demographic variables among the groups. At the intraoperative period, end of surgery, and postoperative first hour the mean VPS in the lidocaine group was significantly higher than the others (P<0.01), but no significant difference was found between the levobupivacaine and ropivacaine groups. At incision and 24 h after surgery, it was not significantly different among the groups. Surgeon and patient satisfaction scores were significantly better in the levobupivacaine and ropivacaine groups than in the lidocaine group (P<0.01).


CONCLUSIONS
Topical anaesthesia with levobupivacaine and ropivacaine were safe, feasible and more effective than lidocaine in cataract surgery. Levobupivacaine and ropivacaine provided sufficient and long-lasting analgesia without the need of supplemental anaesthesia for each patient.
Borazan
M
M
Department of Ophthalmology, Başkent University School of Medicine, Ankara, Turkey. borazan74@hotmail.com
Karalezli
A
A
Akova
Y A
YA
Algan
C
C
Oto
S
S
D000287:Administration, Topical; D000368:Aged; D000577:Amides / Q000008:administration & dosage*; D000772:Anesthesia, Local / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D002387:Cataract Extraction / Q000379:methods; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods; D000077554:Levobupivacaine; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy; D017060:Patient Satisfaction; D018918:Phacoemulsification / Q000379:methods*; D000077212:Ropivacaine; D016896:Treatment Outcome