Clinical efficacy and pharmacokinetics of 1% ropivacaine and 0.75% bupivacaine in peribulbar anaesthesia for cataract surgery

Abstract

SummaryPeribulbar anaesthesia with 1% ropivacaine and 0.75% bupivacaine, both with hyaluronidase, was assessed in a prospective, randomised, double-blind study of 100 patients undergoing cataract surgery. Pharmacokinetic data were obtained from 22 subjects. Akinesia of the globe developed slightly more rapidly in the ropivacaine group, but this difference was only statistically significant at 2 min after injection of the local anaesthetic. Lid akinesia was significantly more complete in the ropivacaine group. There were no differences between the groups with respect to peri-operative analgesia or duration of akinesia. The dose-adjusted maximum concentration of ropivacaine was approximately twice that of bupivacaine with significantly higher values of the area under the concentration-time curves. No drug-related adverse effects were observed. We conclude that there are no clinically significant differences in the quality of the sensory and motor block between 1% ropivacaine and 0.75% bupivacaine when used for peribulbar anaesthesia.

A prospective, randomized, double-blinded comparison of ropivacaine 0.5%, 0.75%, and 1% ropivacaine for peribulbar block

“…Similar results with 1% ropivacaine concentration have been reported by Huha et al 10 who demonstrated an 80% frequency of complete akinesia 10 minutes after injecting 8 mL of local anesthetic solution. In a previous investigation comparing ropivacaine and a lidocaine-bupivacaine mixture for vitreoretinal surgery, we observed a 10 Ϯ 5 minute onset time of motor block with 0.75% ropivacaine.…”

“…10 We wished to detect a 30% difference in the frequency of globe akinesia 15 minutes after completing the injection between different ropivacaine concentrations, accepting a two-tailed ␣ error of 5% and a ␤ error of 20%. 11 Based on these calculations, the required study size was 21 patients per group.…”

Ropivacaine Versus Bupivacaine-Lignocaine Mixture in Peribulbar Block- A Comparative Study

“…This finding is similar to reduction in IOP when used in peribulbar block. [10,13,14] In a study by Nociti JR, despite similar blockade with analgesia and akinesia 1% ropivacaine decreased the intraocular pressure immediately after its administration, unlike 0.75% bupivacaine which promoted an initial elevation in intraocular pressure followed by a reduction. The authors suggested that the difference could be due to the vasoconstrictive action of ropivacaine.…”

“…It has been suggested that in peribulbar anaesthesia, the differences in the potency of the motor blockade between both anaesthetics could be concentrationdependent. [10] Comparison of different concentrations of ropivacaine in 68 patients showed that the concentration of 0.75% is preferable to 0.5% and 1.0%, which produce respectively lower akinesia and prolonged anaesthetic recovery. [4] In a study that compared peribulbar ropivacaine, racemic bupivacaine and levobupivacaine, all in concentrations of 0.75%.…”

Comparison of Efficacy of Peribulbar Block With the Combination of 2% Lidocaine and 0.75% Ropivacaine in Comparison With 2% Lidocaine and 0.5% Bupivacaine for Cataract Surgeries

“…13 D. K. Woodward and A. T. S. Leung et al studied peribulbar anaesthesia with 1% ropivacaine and hyaluronidase 300 IU mL -1 : in comparison with 0.5% bupivacaine, 2% lidocaine and hyaluronidase 50 IU/mL. They showed no difference in the rate of onset and degree of akinesia achieved.…”