Ropivacaine plus lidocaine versus Bupivacaine plus lidocaine for peribulbar double injection regional anesthesia

Our study was designed to evaluate the efficacy of Ropivacaine 0.75% plus Lidocaine 2% versus Bupivacaine 0.5 % plus lidocaine 2 % to provide peribulbar anaesthesia for cataract surgery .Time to adequate block for surgery, ocular eyelid movement scores at 8 min after block and quality for postoperative analgesia were recorded. Sixty patients are randomly divided into two groups of 30, to receive a peribulbar block with 8 – 10 ml of either Ropivacaine – Lidocaine or Bupivacaine – lidocaine,and 15U Hyaluridase per ml with each combination . There was no difference between the two groups in clinical endpoint , Median time at which the block was adequate to start surgery was 8 min. ( 4-10 min ) in each group . Median eyelid movement scores were similar in both groups, yet the lower potential for systemic toxicity of ropivacaine compared with bupivacaine enables it to be used for surgical anesthesia in higher concentration which may facilitate diffusion of local anesthetic molecules into peripheral nervous tissue, improving the onset of nerve blockade.