Tokuda Y, Oshika T, Amano S, Inouye J, Yoshitomi F
Inouye Eye Hospital, Tokyo, Japan.
Graefes Arch Clin Exp Ophthalmol. 2000 Mar;238(3):228-31. doi: 10.1007/s004170050348.
A prospective study was conducted to compare the analgesic effects of sub-Tenon's and retrobulbar anesthesia by assessing patients' response to the visceral stimulus.
Seven hundred and twenty eyes of 720 patients underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation. They received retrobulbar anesthesia with 3 ml lidocaine (225 eyes), retrobulbar anesthesia with 5 ml lidocaine (216 eyes), or sub-Tenon's anesthesia with 3 ml lidocaine (279 eyes). Pain scores were recorded when an acetylcholine chloride solution was injected into the anterior chamber to attain miosis after lens implantation.
Pain scores were significantly different among the three anesthesia groups (P<0.0001, Kruskal-Wallis test). The multiple comparison revealed that analgesic effects were highest with sub-Tenon's anesthesia, followed by 5-ml retrobulbar and 3-ml retrobulbar anesthesia.
Sub-Tenon's anesthesia is an effective and reliable anesthetic method in cataract surgery.
通过评估患者对内脏刺激的反应，进行了一项前瞻性研究以比较球后麻醉和球周麻醉的镇痛效果。
720例患者的720只眼接受了白内障囊外摘除术及后房型人工晶状体植入术。他们分别接受了3毫升利多卡因的球后麻醉（225只眼）、5毫升利多卡因的球后麻醉（216只眼）或3毫升利多卡因的球周麻醉（279只眼）。在晶状体植入后向前房注射氯化乙酰胆碱溶液以诱导瞳孔缩小时记录疼痛评分。
三组麻醉组的疼痛评分有显著差异（P<0.0001，Kruskal-Wallis检验）。多重比较显示，球周麻醉的镇痛效果最佳，其次是5毫升球后麻醉和3毫升球后麻醉。
球周麻醉是白内障手术中一种有效且可靠的麻醉方法。
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