British Journal of Anaesthesia, 2003, Vol. 90, No. 4 512-514
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Short Communications |
Comparison of L-bupivacaine 0.75% and lidocaine 2% with bupivacaine 0.75% and lidocaine 2% for peribulbar anaesthesia
Department of Anaesthesia and Intensive Care Medicine, St George’s Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK
Corresponding author. E-mail: gnichols@sghms.ac.uk
Background. L-Bupivacaine has a safer side-effect profile than bupivacaine. We compared the efficacy of a mixture of L-bupivacaine 0.75% and lidocaine 2% with bupivacaine 0.75% and lidocaine 2% for peribulbar anaesthesia in cataract surgery.
Methods. Ninety patients were allocated randomly to receive 8 ml of a mixture of equal parts of bupivacaine 0.75% and lidocaine 2% or an equal volume of L-bupivacaine and lidocaine 2%. Hyaluronidase 15 IU ml–1 was added to both solutions.
Results. There were significant differences between the groups in clinical end-points. The median time at which the block was adequate to start surgery was 4 min (interquartile range 4–8 min) in the bupivacaine group and 8 min (5–12 min) in the L-bupivacaine group (P=0.002). Median ocular and eyelid movement scores were similarly significantly decreased in the bupivacaine group compared with the L-bupivacaine group at all times (P
0.03). There was no difference between groups in the incidence of minor complications.
Conclusions. A mixture of bupivacaine 0.75% and lidocaine 2% provides faster onset time than a mixture of L-bupivacaine 0.75% and lidocaine 2%.
Br J Anaesth 2003; 90: 512–14