Peribulbar anaesthesia with 1% ropivacaine and hyaluronidase 300 IU ml−1: comparison with 0.5%bupivacaine/2% lidocaine and hyaluronidase 50 IU ml−1

The low toxicity of ropivacaine makes it attractive for peribulbar anaesthesia. However, its motor-sparing properties are undesirable when akinesia is important. Hyaluronidase (300 IU ml−1) promotes the onset and quality of peribulbar blockade when used with other agents. We investigated the onset and quality of ocular akinesia in 80 patients randomized to receive 1% ropivacaine plus hyaluronidase 300 IU ml−1 (group 1), or bupivacaine 0.5%/Lidocaine 2% plus 50 IU ml−1 hyaluronidase (group 2). Ocular akinesia was scored from 0 (no movement) to 8 (full movement) every 2 min for 20 min. The groups showed no difference in the rate of onset or degree of akinesia achieved (analysis of variance with repeated measures; P=0.34). Sixty per cent of patients in group 1 and 55% in group 2 achieved akinesia scores of ≤4 by 6 min (χ2 test; P=0.5). We conclude that both peribulbar solutions produce equivalent onset and quality of ocular akinesia.