Friedman D S, Bass E B, Lubomski L H, Fleisher L A, Kempen J H, Magaziner J, Sprintz M, Robinson K, Schein O D
Department of Ophthalmology, Johns Hopkins University, Baltimore, Maryland, USA.
Ophthalmology. 2001 Mar;108(3):519-29. doi: 10.1016/s0161-6420(00)00597-2.
To synthesize the findings of the randomized trials of regional anesthesia management strategies for cataract surgery.
Literature review and analysis.
The authors performed a systematic search of the literature to identify all articles pertaining to regional anesthesia during cataract surgery on adults. One investigator abstracted the content of each article onto a custom-designed form. A second investigator corroborated the findings. The evidence supporting the anesthesia approaches was graded by consensus as good, fair, poor, or insufficient.
Evidence supporting the effectiveness of different forms of regional anesthesia.
There was good evidence that retrobulbar and peribulbar blocks provide equivalent akinesia and pain control during cataract surgery. Additionally, sub-Tenon's blocks were at least as effective as retrobulbar and peribulbar blocks. There was good evidence that retrobulbar block provides better pain control during surgery than topical anesthesia, and there was fair evidence that peribulbar block provides better pain control than topical anesthesia.
This synthesis of the literature demonstrates that currently used approaches to anesthesia management provide adequate pain control for successful cataract surgery, but there is some variation in the effectiveness of the most commonly used techniques. Data are needed on patient preferences to determine the optimal strategies for anesthesia management during cataract surgery.
综合白内障手术区域麻醉管理策略的随机试验结果。
文献综述与分析。
作者对文献进行系统检索，以确定所有与成人白内障手术期间区域麻醉相关的文章。一名研究人员将每篇文章的内容摘要到一张定制设计的表格上。另一名研究人员对结果进行了核实。支持麻醉方法的证据经共识评定为良好、一般、较差或不足。
支持不同形式区域麻醉有效性的证据。
有充分证据表明，球后阻滞和球周阻滞在白内障手术期间提供等效的眼球运动麻痹和疼痛控制。此外，Tenon囊下阻滞至少与球后阻滞和球周阻滞一样有效。有充分证据表明，球后阻滞在手术期间比表面麻醉提供更好的疼痛控制，有一定证据表明球周阻滞比表面麻醉提供更好的疼痛控制。
该文献综述表明，目前使用的麻醉管理方法可为成功的白内障手术提供充分的疼痛控制，但最常用技术的有效性存在一些差异。需要有关患者偏好的数据来确定白内障手术期间麻醉管理的最佳策略。
