Comparison of articaine and bupivacaine/lidocaine for sub-Tenon's anaesthesia in cataract extraction

Articaine is the most widely used local anaesthetic for dental anaesthesia in Germany, Italy and The Netherlands and has recently been introduced and licensed for dental use in the UK. We have previously shown articaine to be superior to a standard mixture of bupivacaine 0.5%/lidocaine 2% for peribulbar anaesthesia. Sub-Tenon's anaesthesia arguably provides a safer method of anaesthetic delivery for cataract surgery. A blunt cannula is used in this technique, thus greatly reducing the risk of globe perforation, intrathecal injection and sight-threatening periocular haemorrhage. We compared articaine and bupivacaine/lidocaine for sub-Tenon's anaesthesia in cataract surgery. Sub-Tenon's anaesthesia using articaine 2% resulted in a more rapid onset of motor block compared with a bupivacaine/lidocaine (P=0.0076). Ocular movement scores were significantly lower from 2 min after injection until the end of surgery (P=0.031 anova). Articaine 2% is safe and effective for sub-Tenon's anaesthesia and is a suitable alternative to the traditional bupivacaine 0.5%/lidocaine 2% mixture.