Comparison of 0.5% Levobupivacaine and 0.5% Bupivacaine for Retrobulbar Anesthesia in Cataract Surgery

Objective: The aim of the study is to compare the efficacy of local anesthetics, levobupivacaine and bupivacaine, for achievement of retrobulbar anesthesia and to determine patient and surgeon satisfaction in cataract surgery. Material and Methods: One hundred and twenty patients scheduled for cataract surgery were randomised, in a double-blind fashion to receive 5 ml of 0.5% levobupivacaine or 5 ml of 0.5% bupivacaine via inferotemporal injection for achievement of retrobulbar anaesthesia. Motor block durations and pain onset times were recorded. Severity of intra and postoperative pain was assessed by using visual analogue pain scale. The efficiency of anesthesia, patient and surgeon satisfaction, and akinesia durations were assessed by using point scoring scales. Hemodynamic data and adverse events were recorded. Results: Pain on injection (levobupivacaine 18%, bupivacaine 36.7%) was found to be more frequent in group B. The akinesia score after 10 minutes (median; 0, 1 respectively) and sensorial block onset time (2, 3 min) in levobupivacaine group was lower than bupivacaine group but, akinesia scores in both groups were under 4 and adequate for surgery. Surgeon and patient satisfaction regarding anesthesia were also higher in levobupivacaine group (median 10 and 10) compared to bupivacaine group (median 9 and 9) although the medians of two groups were close. Conclusions: Levobupivacaine provides better surgeon and patient satisfaction compared to bupivacaine for retrobulbar anesthesia in cataract surgery, and this finding should be supported by new and comprehensive clinical studies