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Efficacy and comparison of 0.5% levobupivacaine with 0.75% ropivacaine for peribulbar anaesthesia in cataract surgery

Published online by Cambridge University Press:  01 March 2006

A. Di Donato ,
C. Fontana ,
F. Lancia  and
D. Celleno
A. Di Donato
Affiliation:
Concordia Hospital for Special Surgery, Department of Anaesthesia, Intensive Care and Pain Management, Military Policlinic, Winnipeg, Manitoba, Canada
C. Fontana
Affiliation:
Concordia Hospital for Special Surgery, Department of Anaesthesia, Intensive Care and Pain Management, Military Policlinic, Winnipeg, Manitoba, Canada
F. Lancia
Affiliation:
Concordia Hospital for Special Surgery, Department of Anaesthesia, Intensive Care and Pain Management, Military Policlinic, Winnipeg, Manitoba, Canada
D. Celleno
Affiliation:
Isola Tiberina Hospital, Department of Anaesthesiology and Intensive Care, Rome, Italy
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Extract

Summary

Background and objective: The low cardiovascular and neurological toxicity of levobupivacaine has led to its application as a local anaesthetic in a wide variety of specialist applications including peribulbar block for cataract surgery. The aim of this study was to evaluate the efficacy of levobupivacaine 0.5% and to compare block quality vs. ropivacaine 0.75% in peribulbar anaesthesia. Methods: We examined 208 patients subjected to cataract surgery by phacoemulsification who were randomized into two groups according to the anaesthetic used for peribulbar block, namely levobupivacaine 0.5% or ropivacaine 0.75%, both with the addition of hyaluronidase. Nerve block was carried out by injection of 6 mL of the anaesthetic mixture equally distributed between the inferotemporal and superonasal areas. The success of the block was evaluated by determining the time of motor and sensory onset, akinesia score, times of motor and sensory offset and satisfaction of the patient and surgeon after 24 h. Pre-block, post-block and postoperative intraocular pressure as well as the duration of surgical intervention was also determined. Results: With respect to ropivacaine, levobupivacaine showed a significant reduction (P < 0.001) in the average motor and sensory onset. Both the akinesia score (P < 0.01) and mean motor and sensory offset times were also higher (P < 0.001). Neither the average intervention times nor the satisfaction of the patient/surgeon showed any significant differences between the two groups. Conclusions: Levobupivacaine (0.5%) has better anaesthetic properties with respect to 0.75% ropivacaine and is well-suited for peribulbar block in cataract surgery.

Keywords

ANAESTHETICS, LOCAL, levobupivacaine, ropivacaineSURGERY OPHTHALMICANAESTHESIA CONDUCTION, peribulbar block
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 6 , June 2006 , pp. 487 - 490
Copyright
© 2006 European Society of Anaesthesiology

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