A prospective, randomized, double-blinded comparison of ropivacaine 0.5%, 0.75%, and 1% ropivacaine for peribulbar block - 24/08/11
, Umberto Nuti, MD a, *, Roberta Mennella, MD a, *, Monica Scarioni, MD a, *, Elisa Cerchierini, MD a, ‡, Angela Sciascia, MD a‡, Alessandra Garassino, MD a, ‡, Giorgio Torri, MD a, ‡, Francesco Fasce, MD b, †, Gianluigi Bolognesi, MD b, §Abstract |
Study objective |
To evaluate the efficacy of three different concentrations of ropivacaine (0.5%, 0.75%, and 1%) together with a single concentration of hyaluronidase administered for peribulbar block.
Design |
Prospective, randomized, double-blind study.
Setting |
Anesthesia department of a university teaching hospital.
Patients |
68 ASA physical status I, II, and III patients undergoing elective cataract surgery.
Interventions |
Patients were randomly allocated to receive peribulbar block with 6.5 mL of either 0.5% (Group Ropi-5; n = 22), 0.75% (Group Ropi-7.5; n = 22), or 1% ropivacaine (Group Ropi-10; n = 24). In all patients, 0.5 mL of hyaluronidase was added to the local anesthetic solution.
Measurements and main results |
A larger proportion of patients in Groups Ropi-7.5 (82%) and Ropi-10 (83%) showed complete motor block 15 minutes after injection compared with Group Ropi-5 (55%;p = 0.05, andp = 0.03, respectively). Hypotension (reduction of systolic blood pressure by 30% or more from baseline) was observed in two Group Ropi-5 patients (9%), and two Group Ropi-7.5 patients (9%;p = 0.31), whereas bradycardia (reduction in heart rate ≤ 50 bpm) was observed in one Group Ropi-5 patient (4%), and three Group Ropi-10 patients (12%;p = 0.18). Seven hours after surgery, a smaller proportion of Group Ropi-10 patients (64%) showed complete recovery of sensory function as compared with both Group Ropi-5 (94%) and Group Ropi-7.5 (90%;p = 0.03 and p = 0.03, respectively). Complete recovery of motor function 1 hour after surgery was more frequent in Group Ropi-5 (37%) than in Group Ropi-7.5 (5%) or Group Ropi-10 (9%;p = 0.05 and p = 0.05, respectively); however, no other differences in recovery of motor function were observed at any other observation times, with complete recovery in all patients 7 hours after surgery.
Conclusions |
While confirming that ropivacaine is a good option for peribulbar anesthesia, this study demonstrated that the use of 0.75% or 1% concentrations are preferred in that they produce quick and deep sensory and motor block of the operated eye. If recovery of normal motor function is important after surgery, the 0.75% concentration probably represents the best compromise.
Le texte complet de cet article est disponible en PDF.Keywords : Anesthetic technique: peribulbar block, cataract surgery, local anesthesia: ropivacaine, ophthalmologic surgery
Plan
 | Supported in part by a grant from AstraZeneca S.p.A., Assago, Italy. |
Vol 16 - N° 3
P. 184-188 - mai 2004 Retour au numéro
Article précédent
- Preoperative intravenous midazolam: benefits beyond anxiolysis
- Kevin P Bauer, Patrick M Dom, Antonio M Ramirez, Jennifer E O'Flaherty
- Oxidative stress and mitochondrial glutathione in human lymphocytes exposed to clinically relevant anesthetic drug concentrations
- Giovanna Delogu, Adriana Antonucci, Sonia Moretti, Maurizio Marandola, Guglielmo Tellan, Michele Signore, Giuseppe Famularo
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?