阿替卡因与布比卡因/利多卡因用于白内障摘除术中球后麻醉的比较。
Comparison of articaine and bupivacaine/lidocaine for sub-Tenon's anaesthesia in cataract extraction.
作者信息
Gouws P, Galloway P, Jacob J, English W, Allman K G
机构信息
West of England Eye Unit, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK.
出版信息
Br J Anaesth. 2004 Feb;92(2):228-30. doi: 10.1093/bja/aeh044.
BACKGROUND
Articaine is the most widely used local anaesthetic for dental anaesthesia in Germany, Italy and The Netherlands and has recently been introduced and licensed for dental use in the UK. We have previously shown articaine to be superior to a standard mixture of bupivacaine 0.5%/lidocaine 2% for peribulbar anaesthesia. Sub-Tenon's anaesthesia arguably provides a safer method of anaesthetic delivery for cataract surgery. A blunt cannula is used in this technique, thus greatly reducing the risk of globe perforation, intrathecal injection and sight-threatening periocular haemorrhage.
METHODS
We compared articaine and bupivacaine/lidocaine for sub-Tenon's anaesthesia in cataract surgery.
RESULTS
Sub-Tenon's anaesthesia using articaine 2% resulted in a more rapid onset of motor block compared with a bupivacaine/lidocaine (P=0.0076). Ocular movement scores were significantly lower from 2 min after injection until the end of surgery (P=0.031 ANOVA).
CONCLUSION
Articaine 2% is safe and effective for sub-Tenon's anaesthesia and is a suitable alternative to the traditional bupivacaine 0.5%/lidocaine 2% mixture.
背景
在德国、意大利和荷兰，阿替卡因是牙科麻醉中使用最广泛的局部麻醉剂，最近在英国也已引入并获得牙科使用许可。我们之前已表明，在球周麻醉方面，阿替卡因优于0.5%布比卡因/2%利多卡因的标准混合物。对于白内障手术而言，球后麻醉可说是一种更安全的麻醉给药方法。该技术使用钝头套管针，从而大大降低了眼球穿孔、鞘内注射和危及视力的眼周出血风险。
方法
我们比较了阿替卡因和布比卡因/利多卡因用于白内障手术球后麻醉的效果。
结果
与布比卡因/利多卡因相比，使用2%阿替卡因进行球后麻醉导致运动阻滞起效更快（P = 0.0076）。从注射后2分钟直至手术结束，眼球运动评分显著更低（方差分析，P = 0.031）。
结论
2%阿替卡因用于球后麻醉安全有效，是传统的0.5%布比卡因/2%利多卡因混合物的合适替代品。
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