Articaine versus bupivacaine/lidocaine mixture in episcleralperibulbar anesthesia for cataract surgery: a prospectiverandomized-controlled study

Background Medial episcleral peribulbar anesthesia has been shown to be a valid alternative for ocular regional anesthesia because of the infrequent complications observed. Articaine is a new local anesthetic drug used in eye surgery with dense motor block and fewer complications. Aim The aim of this study was to compare the efficacy and safety of an episcleral peribulbar block using articaine 2% versus bupivacaine 0.5%/lidocaine 2% mixture in patients undergoing cataract surgery.Patients and methodsThis study was carried out in Ain Shams University Hospital on 60 patients who underwent elective cataract surgery with peribulbar episcleral anesthesia. Patients were allocated randomly to two groups of 30 patients each. Group A included patients who received peribulbar episcleral anesthesia using 2% articaine as a local anesthetic agent. Group B included patients who received peribulbar episcleral anesthesia using a mixture of 0.5% bupivacaine and 2% lidocaine as a local anesthetic agent. The primary outcome measures were the onset of eye globe akinesia and the ocular mobility score. The secondary outcome measures were the need for a supplementary injection and the occurrence of complications.ResultsIn terms of eye globe akinesia, there were statistically significant differences between the two groups in the onset of satisfactory globe akinesia. Group A showed rapid onset, whereas group B had delayed onset of action. The onset of satisfactory globe akinesia with an ocular mobility score less than 4 was achieved in 4.44 ± 0.76 min in group A (articaine group) compared with 8 ± 0.85 min in group B (bupivacaine/lidocaine mixture group).ConclusionThe current study showed that the episcleral peribulbar technique with 2% articaine and epinephrine 5 μg/ml was effective and provided a superior option to a mixture of 0.5%bupivacaine/2% lidocaine.