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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
VASQUEZ, Carlos Escobar; MACUCO, Marcelo Vechi; BEDIN, Antonio and CASTRO, Renato Almeida Couto de. Comparison of ophthalmic periconal blockade with 1% and 0.75% ropivacaine with lateral infraorbital and medial canthus punctures. Rev. Bras. Anestesiol. [online]. 2002, vol.52, n.6, pp. 681-688. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942002000600004.
BACKGROUND AND OBJECTIVES: Several drugs and methods are used for peribulbar blockade. Our objective was to investigate the quality of ophthalmic periconal blockade by the double puncture technique, with different ropivacaine concentrations and without hyaluronidase. METHODS: Participated in this study fifty patients submitted to ophthalmologic surgery, who were randomly allocated in two groups: R1 (1% Ropivacaine) and R0.75 (0.75% Ropivacaine). Local anesthetic volume was adjusted according to the tole- rance and elasticity of the periconal space at the infraorbital site and, when necessary, not more than 3 ml were used at the medial canthus site. Motor function scores were attributed to each rectus muscle. Motor block of the levator palpebrae superioris and orbicularis muscles was also evaluated. Data were evaluated in the following moments: M0 = immediately before blockade; M5 = 5 minutes after blockade; M 10= 10 minutes after blockade; and M15 = 15 minutes after blockade. RESULTS: Two R1 patients and eight R0.75 patients needed complementation and this difference was significant. In 72% of cases only 2 initial punctures were performed in both groups. Total anesthetic volume and first puncture volume were, respectively, for R1: 9.72 ± 2.38 ml and 6.96 ± 0.97 ml; and for R0.75: 12.64 ± 5.10 ml and 7.36 ± 1.07 ml, also with significant differences. There were significant motor function score differences in moments M10 (R1 = 1.6; R0.75 = 3.8) and M15 (R1 = 1.04; R0.75 = 2.8). CONCLUSIONS: We concluded that 1% ropivacaine is more effective than 0.75% ropivacaine when no hyaluronidase is used to perform ophthalmic periconal blockade by the double puncture technique. There was a trend to less punctures with 1% ropivacaine and a significantly lower number of patients needed complementation in this same group.
Keywords : ANESTHETICS [Local]; ANESTHETICS [ropivacaine]; ANESTHETIC TECHNIQUES [Regional]; ANESTHETIC TECHNIQUES [periconal blockade]; SURGERY [Ophthalmologic].