Allman K G, Barker L L, Werrett G C, Gouws P, Sturrock G D, Wilson I H
Department of Anaesthesia, Royal Devon and Exeter Hospital, UK.
Br J Anaesth. 2002 May;88(5):676-8. doi: 10.1093/bja/88.5.676.
Articaine is a novel amide local anaesthetic with a shorter duration of action than prilocaine.
In a randomized, double-blind study we compared the efficacy of 2% articaine with epinephrine 1:200,000 with a mixture of 0.5% bupivacaine and 2% lidocaine with epinephrine 1:200,000 for peribulbar anaesthesia in cataract surgery using a single inferotemporal injection. Eighty-two patients were randomly allocated to one of two groups to receive peribulbar anaesthesia with 6-7 ml of articaine or a bupivacaine/lidocaine mixture. Both solutions contained hyaluronidase 30 iu ml(-1). Ocular movement was scored at 2 min intervals up to 10 min, at the end of surgery and at time of discharge from hospital. Time to readiness for surgery and any complications (proptosis, chemosis, pain) were recorded.
The articaine group demonstrated a rapid onset of peribulbar block with mean time (SD) to readiness for surgery of 4.2 (4.5) min compared with 7.2 (5.7) min in the bupivacaine/lidocaine group (P=0.0095). The block obtained in the articaine group was dense with eye movement scores at 2, 4, 6, 8 and 10 min all significantly reduced (P<0.01 at each interval). There was also a faster offset of the block in the articaine group (P=0.0009). There was no difference in incidence of minor complications between the groups.
Two per cent articaine is safe and effective for peribulbar anaesthesia by inferotemporal injection and is a suitable alternative to the traditional mixture of 0.5% bupivacaine and 2% lidocaine.
阿替卡因是一种新型酰胺类局部麻醉药，其作用持续时间比丙胺卡因短。
在一项随机双盲研究中，我们比较了含1:200,000肾上腺素的2%阿替卡因与含1:200,000肾上腺素的0.5%布比卡因和2%利多卡因混合物用于白内障手术颞下象限单次球周麻醉的效果。82例患者被随机分配至两组之一，接受6 - 7毫升阿替卡因或布比卡因/利多卡因混合物进行球周麻醉。两种溶液均含有30 iu ml⁻¹透明质酸酶。每隔2分钟对眼球运动进行评分，直至10分钟、手术结束时及出院时。记录手术准备就绪时间及任何并发症（眼球突出、结膜水肿、疼痛）。
阿替卡因组球周阻滞起效迅速，手术准备就绪的平均时间（标准差）为4.2（4.5）分钟，而布比卡因/利多卡因组为7.2（5.7）分钟（P = 0.0095）。阿替卡因组获得的阻滞效果浓密，在2、4、6、8和10分钟时的眼球运动评分均显著降低（每个时间间隔P < 0.01）。阿替卡因组阻滞消退也更快（P = 0.0009）。两组间轻微并发症发生率无差异。
2%阿替卡因经颞下象限注射用于球周麻醉安全有效，是0.5%布比卡因和2%利多卡因传统混合物的合适替代药物。
