• S V Raman, J S Barry, S Murjaneh, J Jacob, A Quinn, G Sturrock, S Shaw, and K Allman.
• Royal Eye Infirmary, Apsley Road, Plymouth PL4 6LP, UK. Vasant317@yahoo.com
• Br J Ophthalmol. 2008 Apr 1;92(4):496-9.

Background/Aims[corrected] The aim of this study was to compare the efficacy and safety of 4% articaine with a mixture containing equal volumes of 2% lidocaine and 0.5% levobupivacaine without hyaluronidase for sub-Tenon's anaesthesia in phacoemulsification cataract surgery.MethodsThe study was a prospective, randomised double-masked clinical trial of 65 patients allocated to receive either 4% articaine or a mixture containing equal parts of 2% lidocaine and 0.5% levobupivacaine. All patients had pre- and postoperative Hess charting to document ocular motility dysfunction. Ocular and eyelid movements were scored at 2 min intervals from 2 to 10 min after injection of the anaesthetic agent, and at the end of surgery. Complications related to injection, including pain, chemosis and subconjunctival haemorrhage, were recorded. Patients rated pain (none/mild/moderate/severe) during surgery. The operating surgeon masked to the anaesthetic agent assessed proptosis/chemosis at the start of the operation and the degree of ocular akinesia and analgesia at the end of surgery.ResultsThe articaine group demonstrated a rapid onset of ocular akinesia with a mean time to readiness for surgery (achieving a score of ConclusionArticaine (4%) is a safer and a superior anaesthetic agent than a mixture of 2% lidocaine and 0.5% levobupicaine in achieving ocular akinesia for sub-Tenon's block in phacoemulsification cataract surgery.

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