Toxicity of intraocular lidocaine and bupivacaine

Am J Ophthalmol. 1998 Feb;125(2):191-6. doi: 10.1016/s0002-9394(99)80091-9.


Purpose: To study the toxicity of intraocular lidocaine, bupivacaine, and a combination of the two anesthetics.

Methods: The right eyes of 34 rabbits were divided into eight groups, and each was injected intravitreally with 0.2 ml of lidocaine hydrochloride in a 2%, 1%, 0.5%, or 0.25% concentration, or bupivacaine hydrochloride in a 0.75%, 0.5%, or 0.25% concentration, or a 1:1 mixture of lidocaine 2% and bupivacaine 0.75%. The left eyes of four of these rabbits received an injection of balanced saline solution. Electroretinograms were recorded before injection and 30 minutes, 90 minutes, 3 hours, 6 hours, 24 hours, and 1 week after injection. The amplitude and the implicit time were analyzed. The rabbits were killed 1 week after injection and the eyes evaluated histologically.

Results: No adverse clinical reaction and no histologic abnormality was observed in any of the nine groups after injection. The a- and b-waves of the electroretinograms in the control group injected with balanced saline solution, and the a-waves of the experimental groups that received injections of lidocaine, bupivacaine, or the mixture, were normal. The b-waves of the experimental groups demonstrated a marked decrease in the amplitude and an increase (P < .05) in the implicit time after intravitreal injection. Electroretinogram responses recovered within 24 hours.

Conclusions: Intravitreal injection of 0.2 ml of lidocaine up to 2%, or of bupivacaine up to 0.75%, and the mixture of lidocaine 2% and bupivacaine 0.75%, induced reversible electroretinogram changes in the rabbit retina. No histologic abnormalities were observed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anesthetics, Local / toxicity*
  • Animals
  • Bupivacaine / toxicity*
  • Drug Combinations
  • Electroretinography / drug effects
  • Injections
  • Lidocaine / toxicity*
  • Ophthalmic Solutions
  • Rabbits
  • Retina / drug effects*
  • Retina / pathology
  • Vitreous Body / drug effects


  • Anesthetics, Local
  • Drug Combinations
  • Ophthalmic Solutions
  • Lidocaine
  • Bupivacaine