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British Journal of Anaesthesia, 2001, Vol. 86, No. 6 876-878
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Efficacy of varying concentrations of hyaluronidase in peribulbar anaesthesia

C. Mantovani1, A. E. Bryant2 and G. Nicholson2

1Department of Anaesthesia, Bromley Hospital, Cromwell Avenue, Bromley, Kent BR2 9AJ, UK. 2Department of Anaesthesia and Intensive Care Medicine, St George’s Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK*Corresponding author

We have compared the efficacy of adding varying concentrations of hyaluronidase to a standard mixture of 2% lidocaine and 1% ropivacaine to provide peribulbar anaesthesia for cataract surgery. We used (i) the time to adequate anaesthesia for surgery and (ii) ocular and eyelid movement scores at 8 min after block as clinical endpoints. Ninety patients were randomly allocated to receive 7–10 ml of equal volumes of 2% lidocaine and 1% ropivacaine without hyaluronidase or with hyaluronidase 15 IU ml–1or 150 IU ml–1. Median time at which the block was adequate for surgery was 6 min in all groups (interquartile range 4–12 min). Median eyelid movement scores were similar in all groups, but the ocular movement scores at 8 min were significantly lower in the group which received hyaluronidase 150 IU ml–1 than in the group not given hyaluronidase (P<0.03). There were no differences between groups in the incidence of minor complications. A high concentration of hyaluronidase resulted in a statistically significantly lower ocular movement score at 8 min; the clinical relevance of this finding is uncertain.

Br J Anaesth 2001; 86: 876–8


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