Weindler J, Weindler M, Ruprecht K W
Augen-Praxis-Klinik, Esslingen.
Ophthalmologe. 2004 Aug;101(8):847-64; quiz 865. doi: 10.1007/s00347-004-1080-7.
In recent years anesthesia modalities have changed in ophthalmic surgery. A growing trend toward the use of topical anesthesia in cataract surgery is apparent. The present-day techniques used in ophthalmic surgery are retrobulbar anesthesia, peribulbar anesthesia, subtenon anesthesia, and subconjunctival anesthesia as injection techniques, topical anesthesia using drops, gel, or sponge, and intracameral anesthesia. Injectable anesthesia (RBA, PBA, STA) provides a higher level of analgesia and globe akinesia. With injection techniques the risks of vis a tergo and anesthetic complications increase; the level of analgesia after topical anesthesia could be improved by supplementation with i.v. narcotics.
近年来,眼科手术中的麻醉方式发生了变化。白内障手术中使用局部麻醉的趋势日益明显。眼科手术目前使用的技术包括球后麻醉、球周麻醉、眼球筋膜下麻醉和结膜下麻醉等注射技术,使用滴剂、凝胶或海绵的局部麻醉,以及前房内麻醉。注射麻醉(球后麻醉、球周麻醉、眼球筋膜下麻醉)可提供更高水平的镇痛和眼球运动不能。采用注射技术时,逆行性视功能障碍和麻醉并发症的风险会增加;通过静脉注射补充麻醉剂可提高局部麻醉后的镇痛水平。