Comparison of 1% ropivacaine with 0.75% bupivacaine and 2% lidocaine for peribulbar anaesthesia

We have compared the efficacy of 1% ropivacaine with a mixture of 0.75% bupivacaine and 2% lidocaine for peribulbar anaesthesia in cataract surgery. We used the time to adequate block for surgery, and ocular and eyelid movement scores at 8 min after block as clinical endpoints. Ninety patients were allocated randomly to receive 7-10 mi of a mixture of equal parts of 0.75% bupivacaine and 2% lidocaine or an equal volume of 1% ropivacaine alone. Hyaluronidase 15 iu ml(-1) was added to both solutions. There were no differences between groups in clinical end-points. Median time at which the block was adequate to start surgery was 8 min (interquartile range 4-10 min) in each group. Median eyelid movement scores were similar in both groups, but the bupivacaine and lidocaine mixture produced a significantly decreased ocular movement score at 2, 4 and 6 min (P<0.05). There was no difference between groups in the incidence of minor complications. Based on clinical end-points, time to adequate block for surgery and median ocular and eyelid movement scores at 8 min, 1% ropivacaine as the sole agent for peribulbar anaesthesia was comparable with a mixture of 0.75% bupivacaine and 2% lidocaine.