A Comparative Study of 2% Lidocaine Plus 0.5% Ropivacaine Versus 2% Lidocaine Plus 0.5% Bupivacaine for Peribulbar Anaesthesia in Cataract Surgeries
Authors/Creators
- 1. MD Anaesthesiology and Critical Care, Assistant Professor, Anaesthesiology (ECMO), Department of CTVS, S.C.B. Medical College & Hospital, Cuttack, Odisha, India
- 2. Assistant Professor, Department of Ophthalmology, M.K.C.G. Medical College & Hospital, Berhampur, Odisha, India
- 3. MD Physiology, Assistant Professor, Department of Physiology, S.C.B. Medical College & Hospital, Cuttack, Odisha, India
- 4. Professor & HOD, Department of Pharmacology, Bhima Bhoi Medical College & Hospital, Balangir, Odisha, India
- 5. Associate Consultant, Critical Care Medicine, AMRI Hospital, Bhubaneswar, Odisha, India
Description
Background: Generally, to perform the Peribulbar anaesthesia, different mixtures of local anaesthetics are used, the most common of which are lidocaine and bupivacaine. It was observed that overdose of bupivacaine proves to be serious because of its cardiotoxic effects. Even more it responded poorly to the traditional resuscitation methods. This study evaluated the efficacy of bupivacaine and ropivacaine. To assess the efficacy hyaluronidase and lidocaine were used to combine the two. Here, for the patients of cataract surgery, two-point injection technique was used for peribulbar anaesthesia. Aim: To assess bupivacaine’s and ropivacaine’s efficacy each of which were combined with hyaluronidase and lidocaine. Material and Methods: It was a randomized double-blind study performed at the Department of Anaesthesia and Critical Care at the Srirama Chandra Bhanja Medical College & Hospital in Cuttack during the period of October 2014-16 on sixty patients admitted for cataract surgery in the peribulbar division. Group A of 30 patients received 3ml of 0.5% ropivacaine plus 4ml of 2% lidocaine plus 22.5 International Unit (IU) of Hyaluronidase, and Group B of 30 patients received 3ml of 0.5% bupivacaine plus 4ml of 2% lidocaine plus 22.5 International Unit (IU) of Hyaluronidase. Results: The study found significant difference in Onset of akinesia (mins) between two groups (p<0.001). Further, in Group A, there was no highly significant change in intraocular pressure after peribulbar anaesthesia, whereas highly significant increase in intra ocular pressure was observed when compared to preoperative value in Group B. The intraocular pressure and duration of akinesia was significant in the Group B than in Group A. The study further recorded a significant difference in the onset of analgesia between Group A and Group B (p<0.00). Conclusion: On basis of the study, it was concluded that bupivacaine + lignocaine is an inferior alternative to ropivacaine + lignocaine for treating patients with peribulbar anaesthesia to be used in cataract surgeries. This was because of the reason that it has better efficacy without any type of cardiovascular toxicity.
Abstract (English)
Background: Generally, to perform the Peribulbar anaesthesia, different mixtures of local anaesthetics are used, the most common of which are lidocaine and bupivacaine. It was observed that overdose of bupivacaine proves to be serious because of its cardiotoxic effects. Even more it responded poorly to the traditional resuscitation methods. This study evaluated the efficacy of bupivacaine and ropivacaine. To assess the efficacy hyaluronidase and lidocaine were used to combine the two. Here, for the patients of cataract surgery, two-point injection technique was used for peribulbar anaesthesia. Aim: To assess bupivacaine’s and ropivacaine’s efficacy each of which were combined with hyaluronidase and lidocaine. Material and Methods: It was a randomized double-blind study performed at the Department of Anaesthesia and Critical Care at the Srirama Chandra Bhanja Medical College & Hospital in Cuttack during the period of October 2014-16 on sixty patients admitted for cataract surgery in the peribulbar division. Group A of 30 patients received 3ml of 0.5% ropivacaine plus 4ml of 2% lidocaine plus 22.5 International Unit (IU) of Hyaluronidase, and Group B of 30 patients received 3ml of 0.5% bupivacaine plus 4ml of 2% lidocaine plus 22.5 International Unit (IU) of Hyaluronidase. Results: The study found significant difference in Onset of akinesia (mins) between two groups (p<0.001). Further, in Group A, there was no highly significant change in intraocular pressure after peribulbar anaesthesia, whereas highly significant increase in intra ocular pressure was observed when compared to preoperative value in Group B. The intraocular pressure and duration of akinesia was significant in the Group B than in Group A. The study further recorded a significant difference in the onset of analgesia between Group A and Group B (p<0.00). Conclusion: On basis of the study, it was concluded that bupivacaine + lignocaine is an inferior alternative to ropivacaine + lignocaine for treating patients with peribulbar anaesthesia to be used in cataract surgeries. This was because of the reason that it has better efficacy without any type of cardiovascular toxicity.
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IJPCR,Vol14,Issue4,Article34.pdf
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Additional details
Dates
- Accepted
-
2022-03-19
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue4,Article34.pdf
- Development Status
- Active
References
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