Fentanyl as an Additive to Ropivacaine and Lidocaine for Peribulbar Block in Cataract Surgeries - A Randomised Comparative Study

Background and Aims: The peribulbar block for cataract surgery is commonly used. Fentanyl as an adjuvant enhances the anaesthesia provided by local anaesthetics. This study was designed to assess the effect of fentanyl on peribulbar block performed with a combination of 0.75% ropivacaine and 2% lidocaine in patients undergoing cataract surgery. Methodology: This prospective, randomised study included 100 patients undergoing cataract surgery. Patients were randomised into two groups: Group RF (n=50) received 0.75% ropivacaine, 2% lidocaine, and 25 mcg of fentanyl, while Group RS (n=50) received 0.75% ropivacaine, 2% lidocaine, and 0.9% normal saline. The study assessed the onset of sensory and motor blockade, the duration of sensory blockade, postoperative analgesia, and the need for rescue analgesia. Results: The onset of sensory and motor blockade was faster in group RF than in group RS (Sensory block: 2.38 ± 0.5 vs. 3.26 ± 0.69 min, p<0.001), (Motor block: 7.24 ± 1.1 vs. 7.8 ± 1.12 min, p<0.015). Group RF had prolonged sensory blockade (315.4 ± 9.45 vs. 272.8 ± 10.5 min, p<0.001). At 6 and 12 h post-surgery, pain scores were lower in Group RF (p<0.001). The changes in haemodynamic parameters and requirement of rescue analgesia were similar in both groups. Conclusion: Adding fentanyl to ropivacaine and lidocaine for peribulbar block in cataract surgery results in a faster onset, longer duration of anaesthesia, and improved postoperative analgesia, without affecting hemodynamic stability.