london euretina

This meeting has been awarded 20 CME credits

Security Notice

Please note that Kuoni are our only destination management company. Other venders indicating that are operating for the society should be ignored. We never use western union as a payment portal

The efficacy of 0.75% levobupivacaine versus 0.75% ropivacaine with fentanyl for peribulbar anesthesia in vitreoretinal surgery

Session Details

Session Title: Vitreoretinal Surgery II

Session Date/Time: Friday 12/09/2014 | 14:30-16:00

Paper Time: 14:30

Venue: Boulevard C

First Author: : S.M.Dsouza INDIA

Co Author(s): :    N. Kumar   R. Battu   A. Braganza   D. Das   V. Kharbanda   R. Shetty

Abstract Details

Purpose:

To evaluate the anaesthetic efficacy and akinesia in the intra and the postoperative period of 0.5% levobupivacaine versus 0.75% ropivacaine with fentanyl for peribulbar anesthesia in patients undergoing vitreoretinal surgery. Peribulbar anesthesiologic requisites for vitreo-retinal surgery are good analgesia and complete akinesia of extraocular muscles, eyelids, and surrounding areas of face as vitreoretinal surgeries are prolonged and general anaesthesia may not be possible in the high risk groups.

Setting:

The study was done at Narayana superspeciality eye hospital Bangalore which is a tertiary care referral eye hospital.

Methods:

We included 40 patients subjected to vitreoretinal surgery under peribulbar anesthesia and divided in two group I( ropivaciane 0.75% with fentanyl) and group II (levobupivacaine 0.5% with fentanyl).The low cardiovascular and neurological toxicity of levobupivacaine and ropivacaine has led to its application as local anaesthetic in wide variety of specialist applications including peribulbar block for VR surgery. Ropivacaine is an amino amide local anesthetic, one of the xylidide derivatives, like bupivacaine, from which it differs, however, in certain features . Bupivacaine contains equal parts of the dextro and levo-rotatory enantiomers. Ropivacaine, however, is synthesized as the pure levo-enantiomer, which makes it less toxic, with longer-lasting action, owing to differences in the three-dimensional structure of the molecule, which change its activity toward the complex receptor environment that is the anesthetic’s target. To evaluate the anaesthetic efficacy and akinesia in the intra and the postoperative period of 0.5% levobupivacaine versus 0.75% ropivacaine with fentanyl for peribulbar anesthesia in patients undergoing vitreoretinal surgery. Peribulbar anesthesiologic requisites for vitreo-retinal surgery are good analgesia and complete akinesia of extraocular muscles, eyelids, and surrounding areas of face as vitreoretinal surgeries are prolonged and general anaesthesia may not be possible in the high risk groups. .

Results:

The patients were randomized into two equal groups. Nerve block was carried out by injecting 6–8 mL of the LA with the help of 23G needle. Lid akinesia, Onset of action, globe akinesia and duration of akinesia and analgesia in the postoperative period was noted at 0,2 and 5 minutes after the block. Analgesia in the postoperative period using the visual analog score(VAS score). At one,two and 5 mins minutes of the block, globe akinesia was better in ropivacaine with fentanyl than in levobupivaciane with fentanyl. When compared with 0.75% ropivacaine. levobupivacaine provided significantly longer motor block duration(akinesia) 236±74.5 min versus 172±59 min and significantly longer sensory block duration (183±19 min versus 148±35 min, when compared with ropivacaine. Akinesia with ropivacaine was better than levobupiicaine in the intraoperative period. Volume of local anaesthetic was lesser in ropivacaine than levobupivicaine for peribulbar block though not clinically significant .In the postoperative period, the patients in the levobupivacaine group achieved lower values of visual analog score rating scale of pain compared with patients in the ropivacaine group from 4 to 12 hours with addition of fentanyl.

Conclusions:

Ropivacaine with fentanyl provided good akinesia at 0,2,and 5minutes compared to levobupivacaine. Levobupivacaine provided significant longer sensory block(VAS score for pain) duration when compared with ropivacaine with fentanyl. Number of repeat injection with ropivacaine was lesser than levobupivacaine because of its quick onset of action though not clinically significant. Akinesia with ropivacaine was better than levobupivacaine in the intraoperative period. Volume of local anaesthetic was lesser in ropivacaine than levobupivacaine for peribulbar block though not clinically significant.We therefore conclude that, at equipotent doses and concentrations of 0.5% levobupivacaine and 0.75%ropivacaine provided effective postoperative analgesia., but ropivacaine provided immediate akinesia than levobupivacaine.

Back to previous
EURETINA, Temple House, Temple Road, Blackrock, Co Dublin. | Phone: 00353 1 2100092 | Fax: 00353 1 2091112 | Email: euretina@euretina.org

Privacy policyHotel Terms and Conditions Cancellation policy