Peribulbar block for cataract surgery: a prospective double-blind study of two local anesthetics

Can J Ophthalmol. 1989 Jun;24(4):155-8.


We carried out a prospective double-blind study to compare the effectiveness of 2% lidocaine hydrocarbonate (54 patients) and 2% lidocaine hydrochloride plus 0.5% bupivacaine hydrochloride (46 patients) in achieving peribulbar block of the orbit in patients undergoing cataract surgery. A total of 150 IU of hyaluronidase was added to each syringe before injection. Anesthesia was done with a total of 6 mL injected into the periphery of the orbit and a further 3 to 4 mL injected for seventh cranial nerve block. A successful block, defined as akinesis of the globe at 4 minutes after injection, was achieved in 94% of the patients, with no difference between the two groups. Two minor complications (transient lateral rectus paresis and a small retrobulbar hematoma) were observed. We recommend this method of peribulbar block as it has a rapid onset and its use may lead to a reduced occurrence of the central nervous system complications associated with retrobulbar block.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Anesthetics, Local*
  • Bupivacaine / pharmacokinetics*
  • Cataract Extraction*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Humans
  • Hyaluronoglucosaminidase / administration & dosage
  • Lidocaine / pharmacokinetics*
  • Orbit / drug effects*
  • Prospective Studies
  • Time Factors


  • Anesthetics, Local
  • Lidocaine
  • Hyaluronoglucosaminidase
  • Bupivacaine