[Minimum anesthetic volumes for extraconal retrobulbar block: comparison between 0.5% racemic bupivacaine, levobupivacaine and enantiomeric mixture S75/R25 bupivacaine].

Abstract:

BACKGROUND AND OBJECTIVES:Minimum anesthetic volume (MAV) of local anesthetics corresponds to the effective volume for regional anesthesia in 50% of patients. In this study, MAV of 0.5% racemic bupivacaine, 0.5% levobupivacaine and enantiomeric S75/R25 bupivacaine were calculated and compared. METHODS:This study involved two series of patients undergoing cataract extraction. Series 1 patients received either 0.5% racemic bupivacaine (n = 9) or 0.5% levobupivacaine (n = 11). Series 2 patients received either 0.5% racemic bupivacaine (n = 11) or 0.5% enantiomeric S75/R25 bupivacaine (n = 10). Blockades were achieved by single-injection and inferior-lateral approach. Motility of each rectus muscle was assessed 10 minutes later as: 0 (absent), 1 (decreased) or 2 (normal). Total muscle scores represented total eye motility score (TMS). Local anesthetic volume administered to the first patient of each group was 7.4 mL. Subsequent patients received volumes corresponding to 0.1 higher natural logarithm unit (if TME > 2) or lower (if TME < 2) as compared to natural logarithm of preceding volume. Massey and Dixon's formulae were used for MAV calculations. RESULTS:MAVs of bupivacaine in both series were 6 mL and 6.2 mL, respectively. MAVs of levobupivacaine and enantiomeric S75/R25 bupivacaine were 5.7 mL and 5.8 mL, respectively. There were no differences between groups in effective anesthetic volumes. CONCLUSIONS:Similar volumes of 0.5% racemic bupivacaine, 0.5% levobupivacaine and enantiomeric S75/R25 bupivacaine are needed for extraconal retrobulbar anesthesia.

journal_name

Rev Bras Anestesiol

authors

Soares LF,Barros AC,Almeida GP,Boos GL,Oliveira Filho GR

doi

10.1590/s0034-70942005000300002

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

263-5

issue

3

eissn

0034-7094

issn

1806-907X

pii

S0034-70942005000300002

journal_volume

55

pub_type

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