Comparison of efficacy of 2% lidocaine and 0.5% bupivacaine with 2% lidocaine and 0.75% ropivacaine in peribulbar block for cataract surgery.

Cataract surgery is commonly performed under regional anaesthesia using peribulbar blocks. The combination of local anaesthetic agents significantly affects the onset, duration, and efficacy of anaesthesia. This study aimed to compare the efficacy of peribulbar anaesthesia using 2percent lidocaine with 0.75percent ropivacaine versus 2percent lidocaine with 0.5percent bupivacaine in terms of sensory blockade onset, motor blockade onset, and postoperative analgesia duration. Study to be conducted on 164 patients undergoing cataract surgery, who are divided into two groups. One group receive an 8 ml mixture of 2percent lidocaine and  0.75percent ropivacaine, while the control group receive 2percent lidocaine and 0.5percent bupivacaine. The peribulbar block is administered while the patients maintained a primary gaze. Gentle massage is applied to facilitate the spread of the anaesthetic. Sensory block wis assessed by loss of corneal sensation with cotton whisp at 2, 4, 6, 8, and 10 min intervals after injection. Onset of sensory block is taken as time from injection to loss of corneal sensation. Motor block is evaluated in the four quadrants using a 3-point scoring system [Akinesia (ocular movement lesser than1mm), reduced movement (ocular movement greater than 1mm but lesser than 4mm) and normal movements (ocular movement greater than 4mm)]. A total score of less than or equal to 2 indicates a successful block. Once successful block is attained, no further assessment made. Haemodynamic parameters, including systolic, diastolic, and mean arterial pressures, heart rate, and oxygen saturation to be monitered . The quality of the surgical anaesthesia is graded as excellent (no pain), good (minimal pain), or poor (failed block). Postoperatively, pain is assessed using the Visual Analogue Scale (VAS) every 15 min until the score reached greater than or equal to 3. The duration of effective analgesia is recorded from the time of the peribulbar block to the point when the VAS score reached greater than or equal 3. The resolution of motor blockade cant be assessed because the patient’s eyes bandage postoperatively.