A Comparison of Mepivacaine Versus Lidocaine for Episcleral (Sub-Tenon’s) Block for Cataract Surgery in an Ambulatory Setting

Ripart, Jacques; Nouvellon, Emmanuel; Chaumeron, Arnaud; Chanial-Bourgaux, Catherine; Mahamat, Aba

doi:10.1016/j.rapm.2006.03.002

Cited by 1 publication

(3 citation statements)

References 19 publications

(24 reference statements)

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“…Also, mepivacaine group did not experience more pain. 2 Borel et al also recommended using mepivacaine and lidocaine rather than bupivacaine in day case cataract surgeries due to good block and short duration. 26 Fanelli 19 The shorter duration of the block with mepivacaine was likewise expected from its pharmacology.…”

Section: Discussionmentioning

confidence: 99%

“…Ripart et al found no favor with lidocaine over mepivacaine in episcleral (sub-Tenon's) eye block, especially in terms of motor-block duration. 2 Neuromuscular blocking drugs, such as atracurium 27 and vecuronium, 28 have also been added to the local anesthetic mixtures and have been shown to enhance the quality of PBA…”

Section: Discussionmentioning

confidence: 99%

“…1 In such procedures, rapid recovery from the block is always desirable. 2 Peribulbar anesthesia has been developed as a safe, easier, and effective alternative to retrobulbar anesthesia that provides ocular akinesia and anesthesia. 3 Single injection technique is a simple technique that provides efficient regional ocular anesthesia with less complications as compared to classic technique.…”

Section: Introductionmentioning

confidence: 99%

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Comparative efficacy of mepivacaine vs. bupivacaine added to lignocaine plus hyaluronidase for percutaneous peribulbar injection in cataract surgery

Saleh,

Ibrahim,

Zekry

2023

Anaesth. pain intensive care

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Background: Peribulbar anesthesia had been developed as a safer, easier, and effective alternative to retrobulbar anesthesia that provides ocular akinesia and anesthesia. Objective: This study aimed to compare the efficacy of mepivacaine 3% – lidocaine 2% hyaluronidase mixture with that of bupivacaine 0.5% – lidocaine 2% - hyaluronidase to produce optimal operative and post-operative conditions in patients receiving single peribulbar injection for cataract surgery. Patients and Methods: In this randomized, double -blind study, 90 adult patients were assigned to one of two groups (M and B), each comprising 45 patients. Study participants received 6-8 ml combination of equal parts of either mepivacaine 3% (Group M) or bupivacaine 0.5% (Group B) both with lidocaine 2% and hyaluronidase 25 IU/ml. Akinesia was assessed with a 12-point scale at 2, 5, 10 and 15 min after injection. Onset of sensory block, time to start surgery, pain and requirement for supplemental injection were also assessed. Results: Group M showed better akinesia scores than Group B and the onset of globe akinesia and sensory block were significantly faster in Group M. The duration of globe and lid akinesia was longer in Group B (159.16 ± 5.71 min and 150.02 ± 4.42 min, respectively) than in Group M (142.89 ± 6.52 min and 135.69 ± 4.81 min, respectively) and this showed statistical significance (P < 0.001). The percentage of patients who required supplementary injection was significantly higher in Group B (7 patients) compared to that in Group M (2 patients). Conclusion: Using a mixture of mepivacaine and lidocaine gives perfect globe akinesia and quicker establishment of appropriate conditions to start cataract surgery and shortens the block onset time with faster recovery compared with the addition of bupivacaine to lidocaine in peribulbar anesthesia. Trial registration: Registered at http:// www.pactr.org; No. PACTR201810828658359. Dated: October8, 2018. Abbreviations: ASA PS - American Society of Anesthesiologists Physical Status; PACU - Post Anesthesia Care Unit; VRS - Verbal Rating Scale; PBA - Peribulbar Anesthesia Key words: Peribulbar block, Cataract extraction, Mepivacaine, Lidocaine, Bupivacaine. Citation: Saleh AN, Haiba Ali Ibrahim DM, Zekry MR. Comparative efficacy of mepivacaine vs. bupivacaine added to lignocaine plus hyaluronidase for percutaneous peribulbar injection in cataract surgery. Anaesth. pain intensive care 2023;27(5):464−470; DOI: 10.35975/apic.v27i5.2167 Received: April 09, 2023; Reviewed: August 08, 2023; Accepted: August 18, 2023

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Section: Discussionmentioning

confidence: 99%