Comparative study of lignocaine and hyaluronidase versus lignocaine, hyaluronidase, and bupivacaine for peribulbar block in cataract surgery

Abstract

Introduction: Peribulbar block is used to provide anesthesia for cataract surgery. A mixture of 0.5% bupivacaine and 2% lignocaine with hyaluronidase had been widely used for peribulbar blocks. Severe central nervous system and cardiovascular system adverse reactions have been linked to bupivacaine. The aim of this research article is to compare lignocaine plus hyaluronidase versus lignocaine plus hyaluronidase plus bupivacaine for peribulbar block in cataract surgery. Materials and Methods: It included 50 eligible patients who were scheduled for cataract surgery under the peribulbar block and were grouped into two equal groups. Group L was given 4 mL of 2% lignocaine and 15 IU/ML of hyaluronidase per injection and Group B received 4 mL of 0.5% bupivacaine, 4 mL of 2% lignocaine, and 15 IU/ML of hyaluronidase per injection. The time of onset of the effective blockade and adequacy of analgesia and akinesia were assessed. Numerical Rating Scales are used to assess postoperative pain. Supplementary injections were recorded, and the total volume of anesthetic solutions was calculated. Results: The mean volume of local anesthetic solution needed was higher in Group L compared to Group B but the difference was not significant. There was no significant difference in onset time to adequate surgical anesthesia among the groups. The mean duration of akinesia was 6.632 h for Group B compared to 4.804 for Group L. Seventy percent of the bupivacaine group patients required no postoperative analgesia compared to 50% of the lignocaine group. Conclusion: Since cataract surgery is a short duration surgery, lignocaine alone can be routinely used for peribulbar block.