To compare efficacy and safety of sub-tenon and Peribulbar block using different local anesthetic drugs for patients undergoing phacoemulsification.
Materials and Methods:
In this prospective randomaized double blind clinical study, 400 patients were equally divided into two groups: Group A received a Peribulbar block (PB) which equally divded into two subgroups, A1 patients underwent PB using levobupivacaine 0.5%, A2 patients underwent PB using ropivacaine 0.75% pluse rocuronium 0.06mg/kg. Group B : received sub-tenon block which divided into two subgroups B1 patients underwent Sub-tenon block using levobupivacaine 0.5%, B2 patients underwent Sub-tenon block using Ropivacaine 0.75% with rocuronium 0.06mg/kg. Onset of sensory and motor block and Total volume of local anesthetic were calculated.
Ocular Akinesia score, eye lid akinesia score and intraocular pressure (I.O.P) were assessed . The degree of pain was assessed by a verbal numerical pain rating scale(V.N.P.R.S.) . The patients and surgeons satisfaction were assessed. Data were analyzed with the unpaired, two-tailed t-test, analysis of variance and the Chi-square test as appropriate. P < 0.05 was considered statistically significant.
As regard ocular akinesia , The percentage of patients who developed successful akinesia (10 min after block)in peribulbar were significantly higher (P=0.04) in group A2 compared with patients in the group A1 and patients who developed successful akinesia in group B1 were significantly higher (P=0.04) than A1.and patients who developed successful akinesia in group B2 were significantly higher (P=0.03) than A2. In group A the onset of motor block (min) was significantly earlier (P=0.01) in the group A2 compared with the patients in the group A1.
Peribulbar anesthesia using a mixture of rocuronium 0.06mg/kg and ropivacaine0.75% provides optimal orbital and eyelid akinesia for cataract surgery and shortens the block onset time.