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British Journal of Anaesthesia, 2004, Vol. 92, No. 2 231-234
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia


Clinical Investigations

Articaine versus lidocaine plus bupivacaine for peribulbar anaesthesia in cataract surgery

M. Ozdemir*,1, G. Ozdemir1, B. Zencirci2 and H. Oksuz2

1 Department of Ophthalmology and 2 Department of Anaesthesiology, Medical Faculty of Kahramanmaras Sutcu Imam University, T-46050 Kahramanmaras, Turkey

*Corresponding author. E-mail: drmozdemir@hotmail.com

Background. We compared the efficacy and safety of articaine 2% with a mixture of lidocaine 2% and bupivacaine 0.5% without hyaluronidase for peribulbar anaesthesia in cataract surgery.

Method. In this double-blind randomized clinical study, 58 cataract patients were allocated to receive either articaine 2% with epinephrine 1:200 000 or a mixture of equal parts of lidocaine 2% with epinephrine 1.25:100 000 and bupivacaine 0.5%. Ocular and eyelid movement scores, the number of supplementary injections, total volume of solution used and pain and complications during injection and surgery were used as clinical end-points.

Results. Articaine produced greater akinesia after 5 min (P=0.03). Eighteen patients (60%) in the articaine group and 26 (93%) in the lidocaine/bupivacaine group required a second injection (P=0.003). A third injection was needed by two patients (7%) in the articaine group and 12 (43%) in the lidocaine/bupivacaine group (P=0.001). The total mean volume of local anaesthetic required to achieve akinesia was mean 9.4 (SD 1.7) ml in the articaine group and 11.28 (1.86) ml in the lidocaine/bupivacaine group (P<0.001). Median pain score was lower in the articaine group than in lidocaine/bupivacaine group during injection (P=0.004) and surgery (P=0.014). There was no difference between the groups for the incidence of complications.

Conclusion. Articaine 2% without hyaluronidase is more advantageous than a mixture of lidocaine 2% and bupivacaine 0.5% without hyaluronidase for peribulbar anaesthesia in cataract surgery.

Br J Anaesth 2004; 92: 231–4


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T. A. King, J. Mitchell, K. Altman, M. Ozdemir, and K. G. Allman
Articaine for sub-Tenon's and peribulbar anaesthesia in cataract surgery
Br. J. Anaesth., October 1, 2004; 93(4): 595 - 596.
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