Carticaine versus lidocaine for peribulbar anesthesia in cataract surgery

Abstract

Purpose To compare carticaine 4% and lidocaine 2% for peribulbar anesthesia in cataract surgery. Setting Ain Shams and Cairo University Hospitals, Cairo, Egypt. Methods This prospective double-blind randomized study comprised 200 cataract patients assigned to 1 of 2 groups of 100 each based on type of anesthesia: carticaine 4% or lidocaine 2%. The efficacy, safety, and duration of the motor and the analgesic block produced by carticaine 4% adrenaline hyaluronidase mixture and lidocaine 2% adrenaline hyaluronidase mixture used as peribulbar anesthesia were compared. The mean time for satisfactory block, need for supplementary injections, incidence of intraoperative and postoperative pain, and postoperative complications were evaluated. The data were analyzed using the Student t test and Mann-Whitney U test for intergroup differences. The chi-square or Fisher exact test was used to assess eye movement scores, the need for supplementary injections, the onset of postoperative pain, and the incidence of postoperative complications. Results The mean time for satisfactory anesthesia was 7.5 minutes ± 1.68 (SD) for lidocaine 2% and 2.5 ± 1.53 minutes for carticaine 4% ( P < .001). The need for supplementary injections was 28% in the lidocaine group and 4% in the carticaine group ( P < .001). The mean onset of postoperative pain was 2.00 ± 0.86 hours in the lidocaine group and 5.52 ± 1.80 hours in the carticaine group ( P < .05). There were no cases of postoperative neurotoxicity or extraocular muscle dysfunction in either group. Conclusions Carticaine 4% adrenaline hyaluronidase mixture was an effective and safe agent for peribulbar anesthesia. It was more efficient than lidocaine 2% adrenaline hyaluronidase mixture in the onset and quality of anesthesia as well as postoperative analgesia.