• J Soliveres Ripoll, C Solaz Roldán, J Viñoles Pérez, J Seller Losada, R Medel Pérez, and M Barberá Alacreu.
• Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Dr. Peset, Av Gaspar Aguilar, 90 46018 Valencia. soliveres_jua@gva.es
• Rev Esp Anestesiol Reanim. 2002 Aug 1; 49 (7): 356-9.

ObjectiveTo determine whether adding hyaluronidase to 1% ropivacaine without adrenalin enhances peribulbar anesthesia for cataract surgery with phacoemulsification.Patients And MethodsProspective double-blind study of 100 patients (ASA I-III) scheduled for outpatient cataract surgery with peribulbar blockade. The patients were randomized to two groups of 50 to receive either 10 mL of 1% ropivacaine without adrenalin and without hyaluronidase (Group R) or 1% ropivacaine without adrenalin but with 10 U/mL of hyaluronidase (Group RH). We compared the presence of complete akinesia, of adequacy of surgical conditions, and of the need for reinjection. For statistical analysis we used the chi-squared test and a Student t-test for independent samples, with statistical significance at 5%.ResultsA block adequate for surgery was obtained in 98% of the patients in Group RH and in 86.7% of the patients in Group R (p = 0.043). Reinjection was necessary for 28.6% of Group R patients and 8.9% of Group RH patients (p = 0.14). Complete akinesia was similar in the two groups.ConclusionsThe greater efficacy of a peribulbar block with the addition of 10 U/mL of hyaluronidase to 1% ropivacaine without adrenalin, in comparison to 1% ropivacaine alone, was demonstrated by a lower rate of reinjection and ocular mobility, even though no statistically significant difference in either ocular or palpebral akinesia was found.

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