• F Lai, B Sutton, and G Nicholson.
• Department of Anaesthesia and Intensive Care Medicine, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
• Br J Anaesth. 2003 Apr 1; 90 (4): 512-4.

BackgroundL-Bupivacaine has a safer side-effect profile than bupivacaine. We compared the efficacy of a mixture of L-bupivacaine 0.75% and lidocaine 2% with bupivacaine 0.75% and lidocaine 2% for peribulbar anaesthesia in cataract surgery.MethodsNinety patients were allocated randomly to receive 8 ml of a mixture of equal parts of bupivacaine 0.75% and lidocaine 2% or an equal volume of L-bupivacaine and lidocaine 2%. Hyaluronidase 15 IU ml(-1) was added to both solutions.ResultsThere were significant differences between the groups in clinical end-points. The median time at which the block was adequate to start surgery was 4 min (interquartile range 4-8 min) in the bupivacaine group and 8 min (5-12 min) in the L-bupivacaine group (P=0.002). Median ocular and eyelid movement scores were similarly significantly decreased in the bupivacaine group compared with the L-bupivacaine group at all times (PConclusionsA mixture of bupivacaine 0.75% and lidocaine 2% provides faster onset time than a mixture of L-bupivacaine 0.75% and lidocaine 2%.

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