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. 2012 Jan;6(1):22-6.
doi: 10.4103/1658-354X.93050.

The efficacy of 0.75% levobupivacaine versus 0.75% ropivacaine for peribulbar anesthesia in vitreoretinal surgery

Ashraf M Ghali  1
Affiliations

The efficacy of 0.75% levobupivacaine versus 0.75% ropivacaine for peribulbar anesthesia in vitreoretinal surgery

Ashraf M Ghali. Saudi J Anaesth. 2012 Jan.

Abstract

Background: We evaluated the anesthetic efficacy and the postoperative analgesic effects of 0.75% levobupivacaine versus 0.75% ropivacaine for peribulbar anesthesia in patients undergoing primary vitreoretinal surgery.

Methods: We investigated 120 patients subjected to vitreoretinal surgery under peribulbar anesthesia. They were randomized into two equal groups according to the local anesthetic (LA) used, namely, 0.75% levobupivacaine or 0.75% ropivacaine, both with the addition of hyaluronidase. Nerve block was carried out by injection of 5-7 mL of the LA using single injection percutaneous peribulbar anesthesia with a short needle.

Results: When compared with 0.75% ropivacaine, 0.75% levobupivacaine provided more successful akinesia at 10 min after block (P=0.026), fewer supplementary injections (P=0.026), and less volume (mL) was used (P=0.031). Also, levobupivacaine provided significantly longer motor block duration (342±27 min versus 206±40 min, P=0.001) and significantly longer sensory block duration (513±24 min versus 394±11 min, P=0.001) when compared with ropivacaine. In the postoperative period, the patients in the levobupivacaine group achieved lower values of verbal numeric rating scale of pain compared with patients in the ropivacaine group among the period from 4 to 12 h. Also, there were significantly (P=0.001) lower diclofenac consumption (mg) and the percentage of patients who required tramadol rescue medication were significantly less (P=0.034) in the levobupivacaine group compared with the ropivacaine group.

Conclusion: We are concluding that, at equipotent doses and concentrations, 0.75% levobupivacaine provides more effective peribulbar anesthesia and more effective postoperative analgesia for vitreoretinal surgery compared with 0.75% ropivacaine.

Keywords: Levobupivacaine; peribulbar anesthesia; ropivacaine.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
The verbal numeric rating scale of pain 24 h postoperatively
See this image and copyright information in PMC

References

    1. Stewart J, Kellett N, Castro D. The central nervous system and cardiovascular effects of levobupivacaine and ropivacaine in healthy volunteers. Anesth Analg. 2003;97:412–6. - PubMed
    1. Newsom RS, Wainwright AC, Canning CR. Local anaesthesia for 1221 vitreoretinal procedures. Br J Ophthalmol. 2001;85:225–7. - PMC - PubMed
    1. Shende D, Sadhasivam S, Madan R. Effects of peribulbar bupivacaine as an adjunct to general anesthesia on perioperative outcome following retinal detachment surgery. Anaesthesia. 2000;55:970–5. - PubMed
    1. Eke T, Thompson J. The national survey of local anesthesia for ocular surgery II. Survey methodology and current practice. Eye. 1999;13:196–204. - PubMed
    1. Rizzo L, Marini M, Rosati C, Calamai I, Nesi M, Salvini R, et al. Peribulbar anesthesia: A percutaneous single injection technique with a small volume of anesthetic. Anesth Analg. 2005;100:94–6. - PubMed