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Levobupivacaine 0.75% vs. lidocaine 4% for topical anaesthesia: a clinical comparison in cataract surgery

Published online by Cambridge University Press:  01 May 2007

A. Di Donato ,
C. Fontana ,
F. Lancia ,
K. Di Giorgio ,
S. Reali  and
A. Caricati
A. Di Donato
Affiliation:
Concordia Hospital for Special Surgery, Department of Anesthesia, Resuscitation and Pain Management, Rome, Italy
C. Fontana*
Affiliation:
Concordia Hospital for Special Surgery, Department of Anesthesia, Resuscitation and Pain Management, Rome, Italy
F. Lancia
Affiliation:
Concordia Hospital for Special Surgery, Department of Anesthesia, Resuscitation and Pain Management, Rome, Italy
K. Di Giorgio
Affiliation:
Concordia Hospital for Special Surgery, Department of Anesthesia, Resuscitation and Pain Management, Rome, Italy
S. Reali
Affiliation:
Concordia Hospital for Special Surgery, Department of Anesthesia, Resuscitation and Pain Management, Rome, Italy
A. Caricati
Affiliation:
Concordia Hospital for Special Surgery, Department of Anesthesia, Resuscitation and Pain Management, Rome, Italy
*
Correspondence to: Costantino Fontana, Department of Anesthesia, Rescucitation and Pain Management, Via Amiterno N.5, 00183 Rome, Italy. E-mail: [email protected]; Tel: +39067001721/390651600248; Fax: +390623318656/39065136655
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Summary

Background

The aim of this study was to compare the efficacy of topical levobupivacaine drops 0.75% vs. lidocaine drops 4% in cataract surgery.

Methods

We examined 203 patients undergoing cataract surgery by phacoemulsification. They were randomized into two groups: one received four drops of lidocaine 4% and the other received four drops of levobupivacaine 0.75%. The onset and offset times of sensory block were evaluated. Application, intraoperative and postoperative subjective pain was quantified by the patients using a verbal pain score. Complications, rates of supplemental anaesthesia, and the satisfaction of surgeon and patients were also recorded.

Results

The mean sensory onset and offset times were significantly higher for the levobupivacaine group (P < 0.01). Pain score was lower in the levobupivacaine group than in the lidocaine one and the difference was statistically significant at all stages (P < 0.01). The mean satisfaction scores of patients and surgeon were also statistically higher for levobupivacaine (P < 0.01). No significant differences for complications and rates of supplemental anaesthesia were found.

Conclusions

Topical levobupivacaine 0.75% shows the same efficacy and safety as lidocaine 4% in cataract surgery by phacoemulsification. There was an adequate block with a good level of satisfaction of surgeon and patients. Levobupivacaine 0.75% offers a new and acceptable choice for topical anaesthesia in cataract surgery.

Keywords

LIDOCAINELEVOBUPIVACAINESURGERYOPHTHALMICCATARACTANAESTHESIA LOCAL
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 5 , May 2007 , pp. 438 - 440
Copyright
Copyright © European Society of Anaesthesiology 2006

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References

1.Foster, RH, Markham, A. Levobupivacaine: a review of its pharmacology and use as a local anaesthetic. Drugs 2000; 59: 551–579.CrossRefGoogle ScholarPubMed
2.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
3.Lebuisson, DA, Lim, P, Mary, JC, Jolivet, MC. Anesthesie topique pour l’operation de la cataracte de l’adulte. J Fr Ophtalmol 1996; 19 (3): 181–189.Google Scholar
4.Ruschen, H, Celaschi, D, Bunce, C, Carr, C. Randomised controlled trial of sub-Tenon’s block versus topical anaesthesia for cataract surgery: a comparison of patient satisfaction. Br J Ophthalmol 2005; 89: 291–293.Google Scholar
5.Bardocci, A, Lofoco, G, Perdicaro, S, Ciucci, F, Manna, L. Lidocaine 2% gel versus lidocaine unpreserved drops for topical anesthesia in cataract surgery: a randomized controlled trial. Ophthalmology 2003; 110 (1): 144–149.CrossRefGoogle ScholarPubMed
6.Soliman, MM, Macky, TA, Samir, MK. Comparative clinical trial of topical anesthetic agents in cataract surgery: lidocaine 2% gel, bupivacaine 0.5% drops, and benoxinate 0.4% drops. J Cataract Surg 2004; 30 (8): 1716–1720.Google Scholar
7.Mc Lure, HA, Kumar, CM, Ahmed, S, Patel, A. A comparison of lidocaine 2% with levobupivacaine 0.75% for sub-Tenon’s block. Eur J Anaesth 2005; 22: 500–503.Google Scholar
8.Rood, JP, Coulthard, P, Snowdon, AT, Gennery, BA. Safety and efficacy of levobupivacaine for postoperative pain relief after the surgical removal of impacted third molars: a comparison with lignocaine and adrenaline. Br J Oral Max Surg 2002; 40 (6): 491–496.CrossRefGoogle ScholarPubMed
9.Martini, E, Cavallini, GM, Campi, L, Lugli, N, Neri, G, Molinari, P. Lidocaine versus ropivacaine for topical anesthesia in cataract surgery. J Cataract Surg 2002; 28 (6): 1018–1022.CrossRefGoogle ScholarPubMed
10.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
11.Di Donato, A, Fontana, C, Lancia, F, Celleno, D. Efficacy and comparison of 0.5% levobupivacaine with 0.75% ropivacaine for peribulbar anaesthesia in cataract surgery. Eur J Anaesth 2006; 23: 487–490.Google Scholar
12.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.CrossRefGoogle ScholarPubMed