• Retinal detachment surgery and other long-duration ocular procedures can be performed safely with local anesthesia, but a long-acting anesthetic is required. A randomized and masked prospective series of 126 scleral buckling procedures was undertaken to test a mixture of bupivacaine (Marcaine), lidocaine (Xylocaine), and epinephrine against lidocaine and epinephrine.
The data collected show a conclusive superiority of the bupivacaine mixture in longevity of action and overall performance. Also, there was significantly less variability in the quality of anesthesia with the mixture than with lidocaine (P =.0015).
Holekamp TLR, Arribas NP, Boniuk I. Bupivacaine Anesthesia in Retinal Detachment Surgery. Arch Ophthalmol. 1979;97(1):109-111. doi:10.1001/archopht.1979.01020010049012