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British Journal of Anaesthesia, 2001, Vol. 87, No. 4 584-587
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Comparison of articaine and bupivacaine/lidocaine for single medial canthus peribulbar anaesthesia

K. G. Allman1, J. G. McFadyen1, J. Armstrong1, G. D. Sturrock2 and I. H. Wilson1

1Department of Anaesthesia and 2West of England Eye Unit, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK*Corresponding author

In a single-centre, randomized, double-blind study, we compared the efficacy of 2% articaine with that of a mixture of 0.5% bupivacaine and 2% lidocaine for peribulbar anaesthesia in cataract surgery, using a single medial canthus injection technique. Eighty-two patients were allocated randomly to receive 7–9 ml of a mixture of 0.5% bupivacaine and 2% lidocaine or an equal volume of 2% articaine with 1:200 000 epinephrine. Hyaluronidase 30 iu ml–1 was added to both solutions. The degree of akinesia was scored 1, 5 and 10 min after the block, at the end of surgery and at discharge from the day case unit. Primary outcome measures were the difference in ocular movement scores 5 min after block and the need for supplementary inferolateral injections. There was greater akinesia in the articaine group at 5 min (P=0.01). Ten patients (24%) in the articaine group and 21 patients (51%) in the bupivacaine/lidocaine group required a supplementary injection (P=0.02). The mean (SD) volume of local anaesthetic required to achieve adequate block for surgery was 9.7 (2.1) ml in the articaine group and 11.0 (2.2) ml in the bupivacaine/lidocaine group (P=0.01). There was a faster offset of akinesia after surgery in the articaine group (P=0.01). There were no differences between groups in the incidence of reported pain or of minor complications. In our study, 2% articaine with 1:200 000 epinephrine was safe and efficacious for single medial canthus peribulbar anaesthesia.

Br J Anaesth 2001; 87: 584–7


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