Comparative Evaluation of Ropivacaine and Lignocaine with Ropivacaine, Lignocaine, and Clonidine Combination during Peribulbar Anesthesia for Cataract Surgery
Background: Peribulbar is the most commonly used technique of anesthesia in cataract surgery, and ropivacaine is a new amino amide local anesthetic with the safer pharmacological profile.
Aim: A double-blind, prospective, and randomized study carried out in our institution after getting approval from the Ethical Committee, to compare the anesthetic effects of ropivacaine with the combination of ropivacaine and clonidine in the administration of peribulbar block in cataract surgery.
Materials and Methods: A total of 80 patients of both sexes aged 40–80 years of ASA PS Ι, ΙΙ, scheduled for cataract surgery was included in this study. Patients were allocated to two groups 0f 40 each; ropivacaine, lignocaine group (R group) who received peribulbar block with 2.5 ml of lignocaine (2%) + 2.5 ml of ropivacaine (0.75%) + 50 units of hyaluronidase to a total volume of 5 ml and ropivacaine, lignocaine, clonidine group (RC group) received peribulbar block with 2 ml lignocaine (2%) + 2 ml of ropivacaine (0.75%) + 50 units of hyaluronidase +1 μg/kg of clonidine to a total volume of 5 ml. Heart rate (HR), mean arterial pressure (MAP), pulse oximetry (SpO2), intraocular pressure (IOP), and quality of peribulbar block were observed throughout the intraoperative period at regular intervals. Duration of analgesia was observed in the post-operative period.
Results: Demographic characteristics, SpO2 were comparable in both groups. The onset of sensory and motor blockade was significantly earlier in RC group. IOP does not vary significantly in both groups. The HR, MAP was on the lower side in RC group. The duration of analgesia was prolonged in RC group (6.16 h) as compared to R group (3.48 h).
Conclusion: On adding clonidine to local anesthetic agent augments early onset and prolonged offset of sensory analgesia. It also reduces the volume of local anesthetic requirement. They maintain the hemodynamic throughout the procedure.
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