Connelly N R, Camerlenghi G, Bilodeau M, Hall S, Reuben S S, Papale J
Department of Anesthesiology, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
Reg Anesth Pain Med. 1999 Sep-Oct;24(5):426-9. doi: 10.1016/s1098-7339(99)90009-3.
This study was designed to determine whether administration of clonidine as a component of a peribulbar block enhanced analgesia increased sedation, improved akinesia, or decreased intraocular pressure.
A randomized, double-blinded study was undertaken at a University-affiliated tertiary care hospital. Forty outpatients undergoing unilateral cataract surgery by a single surgeon (J.P.) under peribulbar blockade were evaluated. Patients received either 100 microg (1 mL) clonidine or 1 mL preservative-free normal saline mixed with the local anesthetic (7 mL 1% preservative-free lidocaine). A Honan adapter was applied for 10 minutes after block placement. The outcome measures included sedation scores, intraocular pressure (IOP) before and after peribulbar block, need for supplemental block, 24-hour analgesic requirement, and patient satisfaction.
There were no differences between groups with respect to pain, sedation, or satisfaction scores. There was no difference with respect to onset of akinesia. This study revealed no significant difference in baseline IOP and postperibulbar IOP.
Clonidine did not alter, in any appreciable way, the perioperative course for patients undergoing cataract operations. We do not recommend clonidine as a component of a peribulbar block in patients undergoing cataract extraction operations.
本研究旨在确定可乐定作为球周阻滞的一部分使用时，是否能增强镇痛效果、增加镇静作用、改善眼球运动不能或降低眼压。
在一所大学附属三级护理医院进行了一项随机双盲研究。对40例在球周阻滞下由同一位外科医生（J.P.）进行单侧白内障手术的门诊患者进行了评估。患者接受100微克（1毫升）可乐定或1毫升不含防腐剂的生理盐水与局部麻醉剂（7毫升1%不含防腐剂的利多卡因）混合液。球周阻滞放置后使用Honan眼压控制仪10分钟。观察指标包括镇静评分、球周阻滞前后的眼压（IOP）、补充阻滞的需求、24小时镇痛需求以及患者满意度。
两组在疼痛、镇静或满意度评分方面无差异。眼球运动不能的发作方面无差异。本研究显示基线眼压和球周阻滞后眼压无显著差异。
可乐定未以任何明显方式改变白内障手术患者的围手术期过程。我们不推荐在白内障摘除手术患者的球周阻滞中使用可乐定。
