Bournas Panagiotis, Condilis Nicolas, Lioumi Dimitra, Kanellas Dimitrios, Syndikakis Konstantinos, Vaikoussis Emmanuel
Department of Ophthalmology, General State Hospital of Nikaia, Piraeus, Greece.
Ann Ital Chir. 2005 Jul-Aug;76(4):383-8; discussion 388-9.
To compare and estimate the safety and efficacy of a new viscoelastic substance combined with anaesthetic used in phacoemulsification surgery.
Eight hundred seventy-four patients observed at the Department of Ophthalmology and the Department of Family Medicine of the General State Hospital of Nikea-Piraeus (Greece) submitted to a phacoemulsification surgery for cataract during a six-month period were randomly divided into two groups of 437 patients each. All patients were operated using the same scheme of anesthesia, consisting of ropivacaine drops 0.75% and lidocaine gel 2% immediately before surgery. Viscoelastic without anesthetic was used during the operation of the patients of group 1, while the new viscoelastic with anesthetic (sodium hyaluronate 1.5% and lidocaine 1%) (viscoanesthetic) was used in group 2. No intravenous sedation was given to either group. Patients were asked to complete a questionnaire including irritation or pain sensation during various phases of the operation, after the operation, as well as the degree of satisfaction from the anesthesia scheme. The participating surgeons were called to estimate post-operative corneal edema.
In the first group of patients (viscoelastic without anesthetic) 15.6% of them reported pain during intraocular lens insertion, 24.6% reported burning sensation during acetylcholine injection, 17.4% reported pain during placement of the corneal suture, 4.1% immediate postoperative pain and 1.8% night pain. In the second group of patients (viscoelastic with anesthetic) the percentages were 1.8%, 3.2%, 4.3%, 3.6% and 1.4% respectively. 78.9% of the first group and 82.1% of the second group had no corneal edema on the first postoperative day. 91.1% of the patients of the first group and 97.3% of the second group were satisfied.
The new combination of viscoelastic and anesthetic is a safe and efficient choice for the cataract surgeon who uses only anesthetic drops for cataract operations. It minimizes patients' complaints and helps in achieving better cooperation during cataract surgery.
比较并评估一种用于白内障超声乳化手术的新型粘弹性物质与麻醉剂联合使用的安全性和有效性。
在希腊尼凯亚-比雷埃夫斯综合医院眼科和家庭医学科接受为期六个月白内障超声乳化手术的874例患者被随机分为两组，每组437例。所有患者均采用相同的麻醉方案，即在手术前立即使用0.75%罗哌卡因滴眼液和2%利多卡因凝胶。第一组患者手术期间使用不含麻醉剂的粘弹性物质，而第二组使用新型含麻醉剂的粘弹性物质（1.5%透明质酸钠和1%利多卡因）（粘弹性麻醉剂）。两组均未给予静脉镇静。要求患者完成一份问卷，内容包括手术各阶段、术后的刺激或疼痛感，以及对麻醉方案的满意度。参与手术的外科医生被要求评估术后角膜水肿情况。
第一组患者（不含麻醉剂的粘弹性物质组）中，15.6%的患者在人工晶状体植入期间报告疼痛，24.6%的患者在注射乙酰胆碱期间报告有烧灼感，17.4%的患者在放置角膜缝线期间报告疼痛，4.1%的患者术后立即疼痛，1.8%的患者夜间疼痛。第二组患者（含麻醉剂的粘弹性物质组）的相应百分比分别为1.8%、3.2%、4.3%、3.6%和1.4%。术后第一天，第一组78.9%的患者和第二组82.1%的患者没有角膜水肿。第一组91.1%的患者和第二组97.3%的患者表示满意。
对于仅使用麻醉滴眼液进行白内障手术 的外科医生而言，新型粘弹性物质与麻醉剂的组合是一种安全有效的选择。它能将患者的不适降至最低，并有助于在白内障手术期间实现更好的配合。
