A COMPARISON OF ROPIVACAINE AND A MIXTURE OF LIGNOCAINE WITH BUPIVACINE IN PERIBULBAR AND RETROBULBAR BLOCK

Abstract

With current advances in locally infiltrating nerve block techniques and the development of long acting local anaesthetic agent, local anaesthesia become the procedure of choice for most anterior segment ophthalmic surgery.

Traditionally, retrobulbar anaesthesia is considered to be effective, but serious complications have been reported. Many surgeons encouraging the use of peribulbar anaesthesia block as an effective and safer alternative to retrobulbar anaesthesia.

Mixture of lidocaine and bupivacaine theoretically offer"'' significant clinical advantages owing to the rapid onset of lidocair.e and the long duration of action of bupivacaine. However, systemic. and localized reactions can occur usually owing to accidental intravascular injection or to administration of an excessive dose.

In response to reports of cardiovascular toxicity from accidental intravascular injection of bupivacaine, a long lasting amide local anaesthetic was developed. Ropivacaine is less cardiotoxic than bupivacaine. It appears that ropivacaine is slightly less potent than bupivacaine for regional anaesthesia. Ropivacaine also produces blocks of shorter duration than those due to bupivacaine.