Year : 2018 | Volume
: 32 | Issue : 3 | Page : 190--194
Comparison of lignocaine 2% with adrenaline and a mixture of bupivacaine 0.5% plus lignocaine 2% with hyaluronidase for peribulbar block analgesia
Ngangom Sangeeta Devi, K Nareshkumar Singh
Department of Ophthalmology, J.N. Institute of Medical Sciences, Imphal, Manipur, India
Purpose: Lignocaine and bupivacaine are the most freely available local anesthetic agents which may be used alone or in combination for peribulbar block analgesia (PBA) with or without hyaluronidase and epinephrine. A prospective comparative study of two solutions was undertaken to rationalize choice of local analgesic agent for PBA.
Materials and Methods: A randomized, prospective study on 100 middle-aged to elderly patients undergoing cataract extraction was undertaken to compare the efficacy of (1) 2% lidocaine plus epinephrine 1:200,000 (Group 1) or (2) a mixture of 2% lidocaine and 0.5% bupivacaine (2:3 volume per volume mix) (Group 2). A standardized deep peribulbar block technique, akinesia scoring system, analgesia scoring system, and supplemental protocol were followed. The onset of block and supplementation rates to achieve akinesia was recorded by a blinded observer. The time from 1st PBA injection to the completion of surgery (the duration of surgical access) was also recorded.
Results: Significantly better results for akinesia were obtained with the combination of 2% lignocaine plus 0.5% bupivacaine mixed with 50 IU/ml of hyaluronidase at 10 min after injection and also at the end of surgery. However, with regard to analgesia, both 2% lignocaine and 2% lignocaine with 0.5% bupivacaine had a similar effect. Furthermore, the patients in Group 2 showed a significantly reduced need for the first supplemental injection and no need for a second supplemental injection. The incidence of complications was very low in this study. No serious local or systemic complication was encountered.
Conclusion: The combination of 2% lignocaine with 0.5% bupivacaine results in a better quality peribulbar block than 2% lignocaine alone, while perioperative analgesia was found to be similar for both combinations. The former also required less frequent supplementary injections.
Dr. Ngangom Sangeeta Devi
Thangmeiband Lairenhanjaba Leikai, Imphal West - 795 004, Manipur
|How to cite this article:|
Devi NS, Singh K N. Comparison of lignocaine 2% with adrenaline and a mixture of bupivacaine 0.5% plus lignocaine 2% with hyaluronidase for peribulbar block analgesia.J Med Soc 2018;32:190-194
|How to cite this URL:|
Devi NS, Singh K N. Comparison of lignocaine 2% with adrenaline and a mixture of bupivacaine 0.5% plus lignocaine 2% with hyaluronidase for peribulbar block analgesia. J Med Soc [serial online] 2018 [cited 2019 Mar 22 ];32:190-194
Available from: http://www.jmedsoc.org/article.asp?issn=0972-4958;year=2018;volume=32;issue=3;spage=190;epage=194;aulast=Devi;type=0