Comparison of 1% ropivacaine with 0.75% bupivacaine and 2% lidocaine for peribulbar anaesthesia

We have compared the efficacy of 1% ropivacaine with a mixture of 0.75% bup ivacaine and 2% lidocaine for peribulbar anaesthesia in cataract surgery. W e used the time to adequate block for surgery, and ocular and eyelid moveme nt scores at 8 min after block as clinical endpoints. Ninety patients were allocated randomly to receive 7-10 mi of a mixture of equal parts of 0.75% bupivacaine and 2% lidocaine or an equal volume of 1% ropivacaine alone. Hy aluronidase 15 iu ml(-1) was added to both solutions. There were no differe nces between groups in clinical end-points. Median time at which the block was adequate to start surgery was 8 min (interquartile range 4-10 min) in e ach group. Median eyelid movement scores were similar in both groups, but t he bupivacaine and lidocaine mixture produced a significantly decreased ocu lar movement score at 2, 4 and 6 min (P<0.05). There was no difference betw een groups in the incidence of minor complications. Based on clinical end-p oints, time to adequate block for surgery and median ocular and eyelid move ment scores at 8 min, 1% ropivacaine as the sole agent for peribulbar anaes thesia was comparable with a mixture of 0.75% bupivacaine and 2% lidocaine.