Reactions 840 - 24 Feb 2001

★Ropivacaine

First report of diplopia: 9 case reportsNine patients [genders and ages not stated] developed

diplopia following peribulbar anaesthesia with ropivacaineduring cataract surgery.

All of the patients received a single 7ml injection ofperibulbar ropivacaine [‘Naropin’] 10 mg/ml andhyaluronidase. They had all developed diplopia by the time oftheir first review visit on postoperative day 1. Vertical diplopiawas strikingly predominant among the patients. Hypertropiawas evident in most of the operated eyes, with symptoms in astraight-ahead gaze. Patients without primary position tropiaexhibited eccentric fixation or saccades. Depression was themost frequent limited ocular movement and was observed inall of the cases. The next most common limited ocularmovement was elevation. The diplopia resolved in all of thepatients within 30 hours (mean 24.3) of receiving ropivacaine.

Author comment: ‘It is important that if Naropin is used forperibulbar or subtenons anaesthesia that patients are warned ofpotential transient post-operative diplopia’.Wells AP, et al. Diplopia from peribulbar ropivicaine. Clinical and ExperimentalOphthalmology 28: 32-33, Feb 2000 - England 807204160

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of diplopia associated withropivacaine.

1

Reactions 24 Feb 2001 No. 8400114-9954/10/0840-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved