Comparison between Ropivacaine and Ropivacaine with Dexamethasone for Post Operative Analgesia in Peribulbar Block for Small Incision Cataract Surgeries

Title A prospective comparative study between Ropivacaine and Ropivacaine with Dexamethasone for post operative analgesia in peribulbar block for small incision cataract surgeries Background Most of the opthalmic procedures are done under local anaesthesia as the patients being elderly present with intercurrent diseases.1 Ropivacaine is an amino amide local anaesthetic agent with greater margin of safety than Bupivacaine for cardio toxicity and neurotoxicity. Dexamethasone is a long acting glucocorticoid with little mineralocorticoid effect. The efficacy and safety of Ropivacaine for anaesthesia during cataract surgery is well studied abroad, with most of the studies using peribulbar technique and hyaluronidase to facilitate the onset of anaesthesia and akinesia. Limited studies are done with dexamethasone and local anaesthetic for peribulbar block. Ropivacaine is recently being introduced in Indian market and needs to be evaluated in Indian perspective. Objective To compare the effect of 0.75 %Ropivacaine and 0.75 %Ropivacaine with Dexamethasone on post operative analgesia in small incision cataract surgeries Methods We selected 50 ASA physical status I& II patients undergoing small incision cataract surgery after thorough preanaesthetic evaluation in SSIMS& RC, Davangere, Karnataka. Procedure of blocks- After written informed consent from the patients they will be randomized to receive peribulbar anaesthesia using 0.75 % Ropivacaine with hyaluronidase 50 IU/ml in group R (n=25) or 0.75 % ropivacaine and dexamethasone with hyaluronidase 50 IU/ml in groupD (n=25). The investigators performing the injections and assessment will be blinded to the solution used. Peribulbar injection of local anaesthetic will be given by using 25 G, 1 inch needle and drug will be injected until peribulbar fullness was observed or to a maximum volume of 7 ml including Dexamethasone 1mg. Postoperatively, patients were shifted to the post operative ward and time for the first rescue analgesic required was noted. Results Data collected is subjected to statistical analysis. p value