Original Article

Levobupivacaine 0.75% vs. lidocaine 4% for topical anaesthesia: a clinical comparison in cataract surgery

A. Di Donato^a1, C. Fontana^a1 c1, F. Lancia^a1, K. Di Giorgio^a1, S. Reali^a1 and A. Caricati^a1

^a1 Concordia Hospital for Special Surgery, Department of Anesthesia, Resuscitation and Pain Management, Rome, Italy

Summary

Background The aim of this study was to compare the efficacy of topical levobupivacaine drops 0.75% vs. lidocaine drops 4% in cataract surgery.

Methods We examined 203 patients undergoing cataract surgery by phacoemulsification. They were randomized into two groups: one received four drops of lidocaine 4% and the other received four drops of levobupivacaine 0.75%. The onset and offset times of sensory block were evaluated. Application, intraoperative and postoperative subjective pain was quantified by the patients using a verbal pain score. Complications, rates of supplemental anaesthesia, and the satisfaction of surgeon and patients were also recorded.

Results The mean sensory onset and offset times were significantly higher for the levobupivacaine group (P < 0.01). Pain score was lower in the levobupivacaine group than in the lidocaine one and the difference was statistically significant at all stages (P < 0.01). The mean satisfaction scores of patients and surgeon were also statistically higher for levobupivacaine (P < 0.01). No significant differences for complications and rates of supplemental anaesthesia were found.

Conclusions Topical levobupivacaine 0.75% shows the same efficacy and safety as lidocaine 4% in cataract surgery by phacoemulsification. There was an adequate block with a good level of satisfaction of surgeon and patients. Levobupivacaine 0.75% offers a new and acceptable choice for topical anaesthesia in cataract surgery.

(Accepted October 13 2006)

Keywords

• LIDOCAINE;
• LEVOBUPIVACAINE;
• SURGERY;
• OPHTHALMIC;
• CATARACT;
• ANAESTHESIA LOCAL

Correspondence:

^c1 Correspondence to: Costantino Fontana, Department of Anesthesia, Rescucitation and Pain Management, Via Amiterno N.5, 00183 Rome, Italy. E-mail: foncos@tiscali.it; Tel: +39067001721/390651600248; Fax: +390623318656/39065136655