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[表面麻醉下超声乳化白内障吸除术与无镇静球周麻醉所致疼痛的比较]

[Comparison between the pain induced by phacoemulsification with topical anesthesia and by peribulbar anesthesia without sedation].

作者信息

Coelho Roberto Pinto, Weissheimer João, Romão Erasmo, Velasco e Cruz Antonio Augusto

机构信息

Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo.

出版信息

Arq Bras Oftalmol. 2005 Jan-Feb;68(1):45-8. doi: 10.1590/s0004-27492005000100008. Epub 2005 Mar 30.

Abstract

PURPOSE

To compare pain sensation induced by phacoemulsification with topical anesthesia with that by peribulbar anesthesia, without sedation.

METHODS

Using a 10-level visual pain analogue scale, the pain induced by phacoemulsification with topical anesthesia (2% tetracaine drops) was measured in 20 patients. The same scale was used to measure the pain induced by peribulbar anesthesia (2% lidocaine and 0.5% bupivacaine) in 21 patients. The same surgeon performed peribulbar infiltrations and surgeries. The phacoemulsifications were done using clear corneal approach followed by in-the-bag intraocular lens implantation. Pain comparison between the two groups was performed by the non-parametrical U Mann-Whitney test.

RESULTS

The distribution of the pain scores of the patients who underwent cataract extraction with topical anesthesia ranged from 0 to 5 (median value = 2). The scores of the patients who underwent peribulbar infiltration ranged from 0 to 7 (median value = 3). The mean rank of the group of patients who had surgery with topical anesthesia (15.78) was significantly different from the mean rank of the patients who received peribulbar anesthesia (25.98) (p = 0.0057).

CONCLUSION

Without sedation, the pain induced by phacoemulsification with topical anesthesia was milder than the pain induced by peribulbar infiltration.

摘要

目的

比较表面麻醉下超声乳化术与球周麻醉下超声乳化术(均无镇静)所引起的疼痛感觉。

方法

使用10级视觉模拟疼痛量表,对20例接受表面麻醉(2%丁卡因滴眼液)下超声乳化术的患者所产生的疼痛进行测量。用同一量表对21例接受球周麻醉(2%利多卡因和0.5%布比卡因)的患者所产生的疼痛进行测量。同一位外科医生进行球周浸润和手术操作。采用透明角膜切口行超声乳化术,随后行囊内人工晶状体植入术。两组间的疼痛比较采用非参数U曼-惠特尼检验。

结果

接受表面麻醉行白内障摘除术患者的疼痛评分分布为0至5分(中位数 = 2)。接受球周浸润麻醉患者的评分范围为0至7分(中位数 = 3)。表面麻醉下手术患者组的平均秩次(15.78)与接受球周麻醉患者的平均秩次(25.98)有显著差异(p = 0.0057)。

结论

在无镇静的情况下,表面麻醉下超声乳化术所引起的疼痛比球周浸润麻醉所引起的疼痛更轻。

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