Intraocular pressure, quality of block, and degree of pain associated with ropivacaine in peribulbar block:: a comparative randomized study with bupivacaine-lidocaine mixture

PURPOSE. To compare the effects of ropivacaine and bupivacaine-lidocaine combination on intraocular pressure, quality of block, and degree of postoperative pain in peribulbar block. METHODS. The study group involved 32 patients undergoing elective cataract surgery under peribulbar block. Patients were divided into two groups according to the local anesthetic used: Group 1 (n= 16), ropivacaine 0.75%; and Group 2 (n= 16), bupivacaine 0.5%-lidocaine 2% mixture. Intraocular pressure was measured at four time points: before block (control), 1 min after block, 5 min after block, and 15 min after block with Tonopen. Quality of block was evaluated using a three-point scoring system based on the reduction of globe motility. Patients were asked their degree of intraoperative pain by using a five-point verbal rating score after the surgery. RESULTS. Mean values of intraocular pressure after block were significantly lower in Group 1 in comparison to Group 2 (p<0.05, Mann Whitney test). The quality of block was better in Group 2, and the degree of postoperative pain was lower in Group 1 (p<0.05, Mann-Whitney test). CONCLUSIONS. Ropivacaine used in peribulbar block is better than bupivacaine-lidocaine mixture under the same standard conditions in terms of reducing intraocular pressure and postoperative pain in intraocular surgery.