Comparative study to assess the effect of ropivacaine and a mixture of lidocaine and bupivacaine on intraocular pressure after peribulbar anesthesia for cataract surgery

ABSTRACT

Purpose: To compare the efficacy of ropivacaine with a mixture of lidocaine and bupivacaine in peribulbar anesthesia for cataract surgery, in terms of post?block intraocular pressure (IOP). Methods: A one?year comparative study was done to compare two anesthetic solutions in peribulbar anesthesia for cataract surgery, from January 2020 to December 2020 at a tertiary health care hospital. Two hundred patients (40� 70 years of age) planned for small?incision cataract surgery with posterior chamber intraocular lens (IOL) implantation under peribulbar anesthesia were included in the study. A single?site inferotemporal injection was given till a total eyelid drop was observed. The IOP was measured at four time?points before block (control), 1?, 5?, and 15?minute post?block with a tonometer. Results: The 1?minute post?block mean IOP in both the groups was higher than the baseline levels. This reflected raised intraorbital pressure secondary to peribulbar injection of local anesthetic. However, the rise in 1?minute post?block IOP was significantly less in the ropivacaine group. The 5? and 15?min post?block mean IOP values in the ropivacaine group were significantly lower than the corresponding values of the lidocaine?bupivacaine group and baseline (control) ropivacaine values. Conclusion: The results of this study support that ropivacaine as a local anesthetic drug for peribulbar block for small?incision cataract surgery can be a suitable alternative to the lidocaine朾upivacaine combination. Studies involving a larger sample size are required to consider ropivacaine as a superior drug to the lidocaine朾upivacaine combination.