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L. Iacobelli; Ropivacaine 1% In Cataract Surgery: Topical Anesthesia Vresus Peribulbar Block . Invest. Ophthalmol. Vis. Sci. 2004;45(13):285.
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Purpose: the aim of our study was to evaluate different efficacy and security between topical and peribulbar anesthesia with ropivacaine 1% in cataract surgery. Methods: 40 patients, included in this study (age range 60–85 years), were randomized to group A (n 20) or group B (n 20). Phacoemulsification cataract surgery was performed in group A with ropivacaine 1% topical anesthesia (total of 6 drops) while in group B a peribulbar block (4 ml.) without hyaluronidase was used. Pain during surgery was studied with the VAS (visual analogical scale: absent, low, moderate, severe); the ocular akinesia was evaluated through the Nicoll’s Index Motility (score system in 0, 1 and 2: akinesia, reduced motility, normal motility). Results: in group A, 4 patients showed absence of pain, 10 had low pain and 6 moderate pain. Normal motility was present in 18 patients while reduced motility was noted in 2 patients. In group B absence of pain resulted in all 20 patients; akinesia was obtained in 16 patients and reduced motility in 4 of them. Conclusions: Ropivacaine 1% is an excellent local anesthetic both for topical and peribulbar use. The topical anesthesia is a good and rapid alternative to peribulbar block, but only expert surgeons should use it. About the peribulbar block, a rapid and total analgesia and akinesia was obtained in the large part of patients and no pain during injection was observed in all 20 patients: this was due also to the vasodilatation action of ropivacaine that has been demonstred only for 1% concentrations.
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