Peribulbar Anesthesia with Either 0.75% Ropivacaine or a 2% Lidocaine and 0.5% Bupivacaine Mixture for Vitreoretinal Surgery: A Double-Blinded Study

Lidocaine versus ropivacaine for continuous interscalene brachial plexus block after open shoulder surgery

“…Previous reports have evaluated mixtures of shorter acting and longer acting anesthetic solutions, such as lidocaine and bupivacaine, for peripheral nerve blocks (12, 13), but no study directly compared short‐ and long‐acting agents for continuous regional analgesia techniques. The main finding in this study was that 0.2% ropivacaine produced a more effective pain control in the early postoperative period with less motor blockade than 1% lidocaine.…”

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

“…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. 6 Reduction of the degree of motor block with reducing concentrations of ropivacaine may be a problem during ophthalmic procedures, in which complete akinesia is important to facilitate surgery. In agreement with our findings, Perello et al 5 reported that injecting more than 9 mL of 0.5% ropivacaine for a retrobulbar anesthesia results in less intense motor block as compared with either a lidocaine-bupivacaine or lidocaine-ropivacaine mixture, with a 10% frequency of supplemental re-injection because of inadequate akinesia.…”

A qualitative study of regional anaesthesia for vitreo‐retinal surgery

“…A peribulbar approach is where an anaesthetic agent is injected into the extraconal orbital space and spreads by pressure and diffusion throughout this area (Gioia et al . ). The sub‐tenon technique is a recent development that requires injection of local anaesthetic agent into the sub‐tenon space via a conjunctival incision (Kallio & Rosenberg , Vohra & Murray , Gill et al .…”

“…As a result, REB anaesthesia as the preferred technique for selected V‐R surgery is now well established (Gioia et al . ). Furthermore, advances in surgical techniques, such as suture‐less 23 and 25 gauge vitrectomy, significantly reduced the duration of surgery and led to a corresponding decrease in the time the patient needed to lie still on the operating table, further diminishing the need for GA (Akçay et al .…”

“…, Gioia et al . ); about the site and techniques of injection (Demediuk et al . , Guise , Clarke et al .…”