Rüschen H, Celaschi D, Bunce C, Carr C
Moorfields Eye Hospital, St Ann's Diagnostic and Treatment Centre, London EC1V 2PD, UK.
Br J Ophthalmol. 2005 Mar;89(3):291-3. doi: 10.1136/bjo.2004.052167.
BACKGROUND/AIM: Sub-Tenon's block (STB) or topical anaesthesia alone (TOP) are popular techniques employed during cataract surgery. TOP is often preferred by healthcare providers because of financial or staffing reasons, despite existing evidence that pain during surgery is better controlled with STB. Pain is not the only consideration that determines patient preference for the anaesthesia technique. The authors decided to investigate the issue of patient satisfaction using the recently developed Iowa Satisfaction with Anesthesia Scale (ISAS).
In a randomised controlled pilot trial, 28 patients were enrolled to receive either STB with 3 ml of 2% lidocaine and hyaluronidase, or TOP with proxymetacaine 0.5% and amethocaine 1% (Tetracaine) eye drops. Postoperatively patients rated their satisfaction with anaesthesia care by filling in the self administered written questionnaire, the ISAS.
One patient in the TOP group dropped out of the study because of intolerable pain. Analysis of the questionnaire results with a two sample Wilcoxon rank sum test showed a significant difference in patient satisfaction (p<0.0085). The median satisfaction score was higher in the STB group 2.77 (interquartile range IQR 2.45 to 3), than in the TOP group 2.04 (IQR 1.54 to 2.5).
In the setting of day case cataract surgery, patients report significantly higher satisfaction scores with STB than with TOP alone.
背景/目的：球后阻滞（STB）或单纯表面麻醉（TOP）是白内障手术中常用的技术。尽管现有证据表明球后阻滞能更好地控制手术中的疼痛，但由于经济或人员配备原因，医疗服务提供者通常更喜欢表面麻醉。疼痛并非决定患者对麻醉技术偏好的唯一因素。作者决定使用最近开发的爱荷华麻醉满意度量表（ISAS）来调查患者满意度问题。
在一项随机对照试验中，招募了28名患者，分别接受3毫升2%利多卡因和透明质酸酶的球后阻滞，或0.5%丙美卡因和1%丁卡因（地卡因）眼药水的表面麻醉。术后患者通过填写自我管理的书面问卷ISAS对麻醉护理的满意度进行评分。
表面麻醉组有1名患者因无法忍受的疼痛退出研究。用两样本Wilcoxon秩和检验分析问卷结果显示，患者满意度存在显著差异（p<0.0085）。球后阻滞组的满意度中位数得分更高，为2.77（四分位间距IQR为2.45至3），而表面麻醉组为2.04（IQR为1.54至2.5）。
在日间白内障手术中，患者报告球后阻滞的满意度得分显著高于单纯表面麻醉。
