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A Clinical comparative study between levobupivacaine 0.5% or Bupivacaine 0.5% both in a mixture with Lignocaine 2% for peribulbar block in cataract surgery

Jigna Shah, Kajal A Bhat.


Abstract

Background and Aim: Local anesthetic techniques are increasingly popular for ophthalmic surgery. Levobupivacine, the pure S (-) enantiomer of bupivacaine, has strongly emerged as a safer alternative2 for regional anesthesia than its racemic sibling, bupivacaine. The present Study was performed with an aim to compare between levobupivacaine 0.5% or Bupivacaine 0.5% both in a mixture with Lignocaine 2% for peribulbar block in cataract surgery
Material and Methods: Participants were evaluated for analgesia and effectiveness of levobupivacaine 0.5 % or bupivacaine 0.5 %, both in a mixture with lidocaine 2% forperibulbar block for cataract surgery. The study was conducted for the period of one year. After routine preanaesthetic assessment (history, physical examination, routine investigation, grading), a peripheral intravenous (i.v.) line was inserted in 6 hours fasted patient and standard monitoring was conducted and recorded, including heart rate (HR), noninvasive arterial blood pressure (BP), electrocardiogram (5 leads), and peripheral oxygen saturation (SpO2). Motor block was evaluated by assessment of akinesia in four quadrants using general akinesia scoring system.
Results: Heart rate after induction is increased in both groups. At the end of surgery, SBP was 128.64 ± 11.517 (mean ± SD) mm Hg in group B while in group L, it was 130.60 ± 16.289 (mean ± SD) mm Hg which was statistically non-significant (p>0.05). At the end of surgery, DBP was 78.84 ± 6.241 (mean ± SD) mm Hg in group B while in group L, it was 79.88 ± 6.799 (mean ± SD) mm Hg which was statistically non-significant (p>0.05). When compared between two groups, there is no significant difference between akinesia score.
Conclusion: Levobupivacaine is a longer acting local anesthetic agent with limited cardio toxicity and neurotoxicity as compared to bupivacaine and may be considered as a landmark for cataract surgery in elderly patient having co-existing systemic diseases

Key words: akinesia, cataract surgery, elderly, levobupivacaine






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