Sheard Richard M, Mehta Jodhbir S, Barry John-S, Bunce Catey, Adams G W
Moorfields Eye Hospital, London, England, United Kingdom.
J AAPOS. 2003 Feb;7(1):38-41. doi: 10.1067/mpa.2003.S1091853103000545.
Ophthalmologists are now encouraged to perform strabismus surgery as an outpatient procedure, but postoperative pain may be a barrier to discharge. Systemic analgesics have side effects or are contraindicated in some patients. We designed a trial to determine the efficacy of subtenons lidocaine injection at reducing postoperative pain and systemic analgesia requirements.
Children having unilateral primary horizontal muscle surgery were randomized to either receive an injection of 1 mL of 2% lidocaine into the inferonasal subtenons space or not. The child's parents, who were masked to the intervention, assessed pain over 4 hours postoperatively using an objective pain-scoring tool.
Seventeen children received injections and 14 did not. Five of the subtenons group required additional analgesia (29%) compared to 9 of the controls (64%, chi(2): P =.052). The pain scores at each time interval tended to be lower in the treatment group, compared to controls, statistically significantly so at the 2-hour observation (Mann-Whitney U test: P =.01).
These data provide some evidence of an association between the use of subtenons lidocaine injection and a reduction of pain experienced by children in the immediate postoperative period following primary strabismus surgery.
目前鼓励眼科医生将斜视手术作为门诊手术进行，但术后疼痛可能会成为出院的障碍。全身性镇痛药有副作用，或在某些患者中为禁忌。我们设计了一项试验，以确定下睑穹窿部注射利多卡因在减轻术后疼痛和减少全身性镇痛需求方面的疗效。
接受单侧原发性水平肌手术的儿童被随机分为两组，一组在鼻下睑穹窿部间隙注射1毫升2%利多卡因，另一组不注射。对干预措施不知情的儿童家长，使用客观疼痛评分工具在术后4小时内评估疼痛情况。
17名儿童接受了注射，14名未接受注射。下睑穹窿部注射组中有5名儿童需要额外镇痛（29%），而对照组中有9名儿童需要额外镇痛（64%，卡方检验：P = 0.052）。与对照组相比，治疗组在每个时间间隔的疼痛评分往往较低，在2小时观察时差异有统计学意义（曼-惠特尼U检验：P = 0.01）。
这些数据提供了一些证据，表明下睑穹窿部注射利多卡因与原发性斜视手术后儿童在术后即刻经历的疼痛减轻之间存在关联。
