The Anesthetic and the Akinetic Effects of 1% Ropivacaine Given in Two Different Peribulbar Blocks; Single Medial Canthus or Double Injection Technique

Background: Owing to the advanced age of patients scheduled for cataract and IOL insertion, and the high concentrations of local anesthetic used in peribulbar blockade, the use of ropivacaine produces an effective motor blockade with minimal risks for neuro and cardiotoxicity.concerning globe injury due to multiple injection the new single injection medial canthus is theoretically preferred to decrease the frequency of globe injury. Aim of the work: To evaluate anesthetic and akinetic Effects in single and double injection peribulbar technique to detect the better method of administration in peribulbar blockade. Methods: This single blind randomized study was done on 60 patients ASA I-III underwent cataract and IOL insertion surgery. Patients were taken peribulbar block using 8 ml, 1% ropivacaine with 30 IU/ml hyalurinidase. Patients were classified into two equal groups; group I (n.30) is the single injection group group II (n.30) is the double injection group. Eye globe and lid akinesia and anesthesia, the need for supplementary injection and the incidence of complications like ecchemosis, high intra ocular pressure nausea, vomiting and pain were recorded. Results: 26 patients (86.6%) of single injection group vs. 28 patients (93.3%) in double injection group were having complete anesthesia and akinesia after giving block; only 4 patients in group I (13.3%) needed supplementation of block vs. 3 patients (10%) in group II with almost no difference in absence of intra and postoperative complications. Conclusions: Single injection peribulbar block with 1% ropivacaine is as effective as the double injection peribulbar block with 1% ropivacaine in cataract surgery providing effective block with fewer possibility for globe injury with multiple injections.