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Abstract #6583 Published in IGR 3-2
Intraocular pressure and ropivacaine in peribulbar block: a comparative study with bupivacaine
Nociti JR; Serzedo PS; Zuccolotto EB; Nunes AM; Ferreira SBActa Anaesthesiologica Scandinavica 2001; 45: 600-602
BACKGROUND: The aim of this study was to compare the effects on intraocular pressure (IOP) of ropivacaine and bupivacaine in peribulbar block. METHODS: The study involved 40 patients with ASA physical status I, II or III undergoing cataract surgery under peribulbar block. Patients were allocated to two groups according to the local anesthetic used: Group R (n = 20), 1.0% ropivacaine and Group B (n = 20) 0.75% bupivacaine, both associated with 50 IU ml-1 hyaluronidase, in peribulbar double injection technique. IOP was measured at four time points: 0 = before block (control); 1 = one minute after block; 2 = five minutes after block; 3 = 15 minutes after block. RESULTS: Mean values of IOP (mmHg) after block were significantly lower in Group R in comparison to Group B: time point 1 = 13.4 ± 3.2 versus 20.8 ± 4.7; time point 2 = 10.9 ± 3.7 versus 14.4 ± 3.8; time point 3 = 7.7 ± 4.0 versus 10.5 ± 3.1. The variation of IOP was different in each group. In Group R, the mean values obtained at the three time points after block were significantly lower than the control; in Group B, the mean value of IOP rose significantly one minute after block and was lower than control only at time point 3. CONCLUSIONS: Ropivacaine 1.0% associated with hyaluronidase in peribulbar block is better than 0. 75% bupivacaine under the same standard conditions for lowering IOP in intraocular surgery. This effect is probably due to relaxation of the extraocular muscles after the block with both anesthetics, and possibly to a smaller intraocular blood volume due to vasoconstriction in the case of ropivacaine.
Dr J.R. Nociti, Department of Anesthesiology, Hospital Santa Casa de Misericordia, Ribeirao Preto, Sao Paulo, Brazil. carp@keynet.com.br
Classification:
12.17 Anesthesia (Part of: 12 Surgical treatment)
