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A prospective, randomised, double-masked comparison of local anaesthetic agents for vitrectomy
  1. Ya-li Zhou1,2,
  2. Yao Tong2,
  3. Yi-xiao Wang1,2,
  4. Pei-quan Zhao2,
  5. Zhao-yang Wang1,2
  1. 1Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
  2. 2Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
  1. Correspondence to Dr Zhao-yang Wang, Department of ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, P.R. China; zhaokekewzy{at}hotmail.com

Abstract

Purpose To compare the intraoperative and postoperative clinical properties of 1% ropivacaine, 0.75% bupivacaine, 2% lidocaine and a mixture of 0.75% bupivacaine and 2% lidocaine (bupi+lido) administered for peribulbar anaesthesia during vitrectomy.

Methods A total of 140 patients were randomly allocated to four groups. The time of onset of analgesia and akinesia was measured. The efficacy of anaesthesia, degree of postoperative pain and intraoperative and postoperative complications were recorded.

Results The mean times of onset (±SD) of analgesia for the ropivacaine, bupivacaine, lidocaine and lido+bupi groups were 90.46±30.08, 94.83±40.72, 78.31±12.56 and 101.51±56.94 s, respectively (p=0.087). The mean times of onset (±SD) of akinesia for the ropivacaine, bupivacaine, lidocaine and lido+bupi groups were 138.89±62.65, 151.86±84.78, 122.66±49.35 and 141.54±62.69 s, respectively (p=0.323). No significant difference was observed in the number of patients who attained grade-5 anaesthesia in the four groups (p=0.966). The outcome of ordered logit analysis showed that the 1% ropivacaine resulted in a significantly lower degree of postoperative pain compared with the other three groups (p=0.017, p=0.001 and p=0.001, respectively). The incidence of postoperative subconjunctival haemorrhage was decreased in the ropivacaine group compared with the other three groups (p<0.001).

Conclusions For peribulbar anaesthesia in vitrectomy, 1% ropivacaine alone provides an adequate intraoperative anaesthesia similar to that provided by the bupivacaine, lidocaine and lido+bupi solutions, as well as provides a better quality of postoperative analgesia and decreases postoperative subconjunctival haemorrhage.

Trial registration number ChiCTR-IPR-16007876; Results.

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Footnotes

  • Contributors Z-yW contributed to the design, interpretation, surgery procedure and made revisions to the manuscript. Y-lZ contributed to experimental data acquisition and wrote the first draft. YT contributed to online registration and data acquisition. Y-xW and P-qZ contributed to the data analysis.

  • Funding This work was supported by Project of the National Natural Science Funds of China (No. 81371040) and Shanghai Pujiang Program (No. 15PJD028).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Ethics Committee of Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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