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British Journal of Anaesthesia, 2000, Vol. 85, No. 4 618-620
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Peribulbar anaesthesia with 1% ropivacaine and hyaluronidase 300 IU ml–1: comparison with 0.5%bupivacaine/2% lidocaine and hyaluronidase 50 IU ml–1

D. K. Woodward1,*, A. T. S. Leung2, M. W. I. Tse2, R. W. K. Law2, D. S. C. Lam2 and W. D. Ngan Kee1

1Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. 2Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China

The low toxicity of ropivacaine makes it attractive for peribulbar anaesthesia. However, its motor-sparing properties are undesirable when akinesia is important. Hyaluronidase (300 IU ml–1) promotes the onset and quality of peribulbar blockade when used with other agents. We investigated the onset and quality of ocular akinesia in 80 patients randomized to receive 1% ropivacaine plus hyaluronidase 300 IU ml–1 (group 1), or bupivacaine 0.5%/Lidocaine 2% plus 50 IU ml–1 hyaluronidase (group 2). Ocular akinesia was scored from 0 (no movement) to 8 (full movement) every 2 min for 20 min. The groups showed no difference in the rate of onset or degree of akinesia achieved (analysis of variance with repeated measures; P=0.34). Sixty per cent of patients in group 1 and 55% in group 2 achieved akinesia scores of <=4 by 6 min ({chi}2 test; P=0.5). We conclude that both peribulbar solutions produce equivalent onset and quality of ocular akinesia.

Br J Anaesth 2000; 84: 618–20.

* Corresponding author: 32 Lemont Road, Sheffield S17 4HA, UK


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