Journal Article

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

K. G. Allman, J. G. McFadyen, J. Armstrong, G. D. Sturrock and I. H. Wilson

in BJA: British Journal of Anaesthesia

Published on behalf of the British Journal of Anaesthesia

Volume 87, issue 4, pages 584-587
Published in print October 2001 | ISSN: 0007-0912
Published online October 2001 | e-ISSN: 1471-6771 | DOI: http://dx.doi.org/10.1093/bja/87.4.584
Comparison of articaine and bupivacaine/lidocaine for single medial canthus peribulbar anaesthesia

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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

Keywords: Keywords: surgery, ophthalmological; anaesthetic techniques, regional, peribulbar; anaesthetics local, articaine

Journal Article.  2286 words.  Illustrated.

Subjects: Anaesthetics

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