Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-14T05:20:54.443Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Foster RH, Markham A. Levobupivacaine: a review of its pharmacology and use as a local anaesthetic. Drugs 2000; 59: 551–579.Google Scholar
Huang YF, Pryor ME, Mather LE et al. Cardiovascular and central nervous system effects of intravenous levobupivacaine and bupivacaine in sheep. Anesth Analg 1998; 86: 797–804.Google Scholar
Lyons G, Columb M, Wilson RC, Johnson RV. Epidural pain relief in labour: potencies of levobupivacaine and racemic bupivacine. Br J Anaesth 1998; 81: 899–901.Google Scholar
Camorcia M, Capogna G. Epidural levobupivacaine, ropivacaine and bupivacaine in combination with sufentanil in early labour: a randomized trial. Eur J Anaesthesiol 2003; 20 (8): 636–639.Google Scholar
Lyons G, Columb M, Wilson RC, Johnson RV. Epidural pain relief in labour: potencies of levobupivacaine and racemic bupivacine. Br J Anaesth 1998; 81: 899–901.Google Scholar
Brahma AK, Pemberton CJ, Ayeko M, Morgan LH. Single medial injection peribulbar anaesthesia using prilocaione. Anaesthesia 1994; 49: 1003–1005.Google Scholar
Woodward DK, Leung ATS, Tse MWI, Law RWK, Lam DSC, Ngan Kee WD. Peribulbar anaesthesia with 1% ropivacaine and hyaluronidase 300 IU mL−1: comparison with 0.5% bupivacaine/2% lidocaine and hyaluronidase 50 IU mL−1. Br J Anaesth 2000; 85: 618–620.Google Scholar
Nicholson G, Sutton B, Hall GM. Comparison of 1% ropivacaine with 0.75% bupivacaine and lidocaine for peribulbar aneaesthesia. Br J Anaesth 2000; 84 (1): 89–91.Google Scholar
Magalhaes E, Goveia CS, Oliveira KB. Racemic bupivacaine, levobupivacaine and ropivacaine in regional anaesthesia for ophtalmology: a comparative study. Rev Assoc Med Bras 2004; 50 (2): 195–198 (Article in Portuguese).Google Scholar
Mc Lure HA, Rubin AP. Comparison of 0.75% levobupivacaine with 0.75% racemic bupivacaine for peribulbar anaesthesia. Anaesthesia 1998; 53: 1060–1064.Google Scholar
Lai F, Sutton B, Nicholson G. Comparison of l-bupivacaine 0.75% and lidocaine 2% with bupivacaine 0.75% and lidocaine 2% for peribulbar anaesthesia. Br J Anaesth 2001; 90 (4): 512–514.Google Scholar
Birt DJ, Cummings GC. The efficacy and safety of 0.75% levobupivacaine vs. 0.75% bupivacaine for peribulbar anaesthesia. Eye 2003; 17 (2) 200–206.Google Scholar
Dempsey GA, Barrett PJ, Kirby IJ. Hyaluronidase and peribulbar block. Br J Anaesth 1997; 78: 671–674.Google Scholar
Hessemer V. Peribulbar anaesthesia versus retrobulbar anaesthesia with facial nerve block. Techniques, local anesthetics and additives, akinesia and sensory block, complications. Klin Monatsbl Augenheilk. 1994; 204 (2): 75–89 (Article in German).Google Scholar
Allman KG, McFadyen JG, Armstrong J, Sturrock GD, Wilson IH. Comparison of articaine and bupivacaine/ lidocaine for single medial canthus peribulbar anaesthesia. Br J Anaesth 2001; 87: 584–587.Google Scholar
Huha T, Ala-Kokko I, Salomaki T, Alahunta S. Clinical efficacy and pharmacokinetics of 1% ropivacaine and 0.75% bupivacaine in peribulbar anaesthesia for cataract surgery. Anaesthesia 1998; 54: 137–141.Google Scholar
Rubin AP. Complications of local anaesthesia for ophthalmic surgery. Br J Anaesth 1995; 75: 93–96.Google Scholar
Gómez-Arnau JI, Yangüela J, González A et al. Anaesthesia-related diplopia after cataract surgery. Br J Anaesth 2003; 90 (2): 189–193.Google Scholar