title: [Peribulbar block with the association of 0.5% enantiomeric mixture of bupivacaine (S75-R25) and 2% lidocaine: effects of hyaluronidase addition.].
abstract: OBJECTIVE
  The benefits of adding hyaluronidase to local anesthetics for peribulbar blockade remain controversial. This study aimed at comparing the effects of hyaluronidase on the akinesia of rectis muscles, elevator muscle of upper eyelid and orbicular muscle of the eye after peribulbar blockade with 0.5% enantiomeric mixture of bupivacaine (S75-R25) and 2% lidocaine.
  
  
  METHODS
  Participated in this study 35 adult patients, who were distributed in group 1, receiving a 1:1 association of 0.5% enantiomeric mixture of bupivacaine (S75-R25) and 2% lidocaine plus epinephrine (5 microg.ml-1), and group 2, receiving the same anesthetic solution with hyaluronidase (50 UI.ml-1). Motility of rectis muscles, elevator muscle of upper eyelid and orbicular muscle of the eye was evaluated at 1, 5, 10 and 15 minutes after blockade.
  
  
  RESULTS
  Extraocular motility scores have significantly decreased during the observation period, without significant differences between groups. The percentage of patients with eyeball akinesia did not significantly differ between groups. Pain at local anesthetic injection site did not differ between groups. Surgical anesthesia was rated as satisfactory by all patients.
  
  
  CONCLUSIONS
  This study could not show any effect of combining hyaluronidase (50 UI.ml-1) and the 1:1 association of 0.5% enantiomeric mixture of bupivacaine (S75-R25) and 2% lidocaine plus epinephrine (5 microg.ml-1) on the akinesia of rectis muscles, elevator muscle of upper eyelid and orbicular muscle of the eye.
authors.affiliation: Hospital Governador Celso Ramos.
authors.forename: Luiz Fernando
authors.initials: LF
authors.lastname: Soares
authors.forename: Pablo
authors.initials: P
authors.lastname: Escovedo Helayel
authors.forename: Diogo Brüggemann da
authors.initials: DB
authors.lastname: Conceição
authors.forename: Getúlio Rodrigues de
authors.initials: GR
authors.lastname: Oliveira Filho