Abstract:

 Objective To analyse and judge the anesthetic effect of lidocaine combined with bupivacaine or ropivacaine in retrobulbar anesthesia in vitreo-retinal surgery. Design Prospective comparative case series. Participants 93 patients treated by 23G were randomly divided into A, B, C groups. Methods For each group, 31 patients underwent retrobulbar anesthesia with different anesthesia drugs (group A: 2% lidocaine 2.25 ml combined with 0.5% bupivacaine 2.25 ml; group B: 2% lidocaine 3 ml combined with 1% ropivacaine 1.5 ml; group C: 2% lidocaine 4.5 ml). The intraoperative anesthestic effect and postoperative pain was recorded. Main Outcome Measures Time of onset of analgesia, akinesia, and intraoperative pain. Results Mean time of onset of sensory blockade for the three groups were 2.10±0.10 min, 2.13±0.11 min and 2.14±0.13 min respectively, there was no significant difference (F=0.800，P=0.456). Mean time of onset of motor blockade for the three groups were 3.10±1.16 min, 3.63±1.11 min and 3.24±1.63 min respectively, there was no significant difference (F=2.000，P=0.138). Mean time of onset of intraoperative pain of three groups were 140.57±22.23 min, 134.44±26.34 min and 87.34±26.53 min respectively, there was significant difference (F=3.500，P=0.035). The time of onset of intraoperative pain of Group A and B was longer than Group C (t=8.5626, 7.0146; all P=0.0001). The number of patients with anesthesia effect rating at level 5 in the three groups was 18, 14 and 9 respectively. Conclusion Lidocaine combined with ropivacaine has the equal anesthesia effect and duration compared to lidocaine combined with bupivacaine. The effect is better than that of using lidocaine anesthesia alone. (Ophthalmol CHN, 2017, 26: 139-142)

Key words: lidocaine, bupivacaine, ropivacaine, retrobullbar anesthesia