Comparison of Articaine and Bupivacaine/Lidocaine for Peribulbar Anesthesia in Cataract Surgery
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- Category: Vol. 80, March 2012
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Comparison of Articaine and Bupivacaine/Lidocaine for Peribulbar Anesthesia in Cataract Surgery,MONA R. FAHIM, HALA M. BAHY EL DEEN, M.D.; RASHAD M. AREF, M.D. and ASHRAF DARWISH
Abstract
Background: Articaine is an amide local anesthetic with a shorter duration of action than prilocaine. We compared the efficacy and safety of articaine 2% to a mixture of bupivacain 0.5% and lidocaine 2% for peribulbar anesthesia in cataract surgery.
Method: In this double-blind randomized clinical study, 100 cataract patients were allocated in two groups to receive peribulbar anesthesia with articaine 2% or a mixture of bupivacaine 0.5% and lidocaine 2% or prilocaine 4%. In the two groups, hyaluronidase 1 0IU/ml was added to the anesthetic mixture. Ocular and eyelid movements at 2 minute intervals for 10 minutes, at the end of surgery and at time of discharge from hospital; number of supplementary injections, total volume of solution used and pain and complications during injection and surgery, and time to readiness for surgery were used as clinical end-points.
Results: The articaine group demonstrated a rapid onset of peribulbar block with mean time (SD) to readiness for surgery of 4.0 (4.4) min compared with 6.9 (5.6) min in the bupivacaine/lidocaine group (p=0.0091). The block obtained in the articaine group was dense with eye movement scores at 2,4,6,8 and 10 minutes all significantly reduced (p<0.01 at each interval). There was faster offset of the block in articaine group (p=0.0008). Less supplementary injections and less local anesthetic volume was noted in the articaine group but with no statistical significance in incidence of minor compli-cations between the two groups.
Conclusion: 2% articaine is safe and effective for peribul-bar anesthesia and is a good competitor to the traditional mixture of 0.5% bupivacaine/2% Lidocaine.