atracurium + lidocaine + bupivacaine + hyaluronidase

This investigational drug combination consists of the intermediate-acting non-depolarizing neuromuscular blocking agent atracurium besylate added to a local anesthetic mixture of lidocaine, bupivacaine, and hyaluronidase. It was evaluated by researchers at Kasr El Aini Hospital for use in percaruncular peribulbar anesthesia during cataract surgery, specifically in patients with high myopia. Atracurium serves as an adjuvant to achieve rapid and complete akinesia of the extraocular muscles by competitively antagonizing nicotinic acetylcholine receptors at the neuromuscular junction. The local anesthetics lidocaine and bupivacaine provide regional anesthesia by blocking voltage-gated sodium channels, while hyaluronidase facilitates the dispersion of the mixture through the orbital tissues by degrading hyaluronan.

Other names

Atracurium in Percaruncular Peribulbar Anesthesia for High Myopes