Habib Nabil E, Mandour Nehal M, Balmer Herbert G R
Royal Eye Infirmary, Plymouth, England.
J Cataract Refract Surg. 2004 Feb;30(2):437-43. doi: 10.1016/S0886-3350(03)00557-1.
To study the effect of sedation on patients' anxiety level and perception of pain during cataract surgery under topical anesthesia.
Royal Eye Infirmary, Plymouth, England.
This prospective controlled double-blind clinical trial comprised 100 consecutive patients having routine phacoemulsification with posterior chamber intraocular lens implantation under topical anesthesia by a single experienced surgeon. Patients were randomized to receive intravenous midazolam (0.015 mg/kg body weight) 15 minutes before surgery or no sedation. The main evaluation criteria were the anxiety based on the 6-item, short form of the State-Trait Anxiety Inventory, the pain score using a visual analog scale, and overall patient satisfaction.
All operations were uneventful, and no side effects were noted from the use of midazolam. Anxiety scores were significantly higher on arrival at the hospital than just before the commencement and after the conclusion of the surgery in both groups (P<.05). Patients were less anxious after administration of midazolam, but this did not achieve statistical significance. The mean pain score was 0.29 (range 0 to 4) in the sedation group and 0.38 (range 0 to 4) in the control group; the difference between groups was not statistically significant. The patients were equally satisfied in both groups, with mean scores of 3.84 (range 0 to 4) and 3.88 (range 2 to 4), respectively.
Patients who had cataract surgery under topical anesthesia were highly satisfied with their operative experience and reported minimal pain during surgery. Anxiety levels diminished after arrival at the hospital, possibly because of reassurance by experienced staff. Intravenous midazolam did not seem to significantly reduce pain or anxiety.
研究镇静对局部麻醉下白内障手术患者焦虑水平及疼痛感知的影响。
英国普利茅斯皇家眼科医院。
这项前瞻性对照双盲临床试验纳入了100例连续接受常规超声乳化白内障吸除联合后房型人工晶状体植入术的患者，手术由同一位经验丰富的外科医生在局部麻醉下进行。患者被随机分为两组，一组在手术前15分钟静脉注射咪达唑仑（0.015毫克/千克体重），另一组不进行镇静。主要评估标准包括基于状态-特质焦虑问卷简式6项版本的焦虑程度、使用视觉模拟量表的疼痛评分以及患者总体满意度。
所有手术均顺利完成，使用咪达唑仑未观察到副作用。两组患者入院时的焦虑评分均显著高于手术开始前和结束后（P<0.05）。给予咪达唑仑后患者焦虑程度降低，但未达到统计学显著性。镇静组的平均疼痛评分为0.29（范围0至4），对照组为0.38（范围0至4）；两组之间的差异无统计学意义。两组患者的满意度相当，平均评分分别为3.84（范围0至4）和3.88（范围2至4）。
接受局部麻醉下白内障手术的患者对手术体验高度满意，且报告手术期间疼痛轻微。入院后焦虑水平降低，可能是因为经验丰富的工作人员给予了安慰。静脉注射咪达唑仑似乎并未显著减轻疼痛或焦虑。
