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0.75%左旋布比卡因与4%利多卡因用于局部麻醉:白内障手术的临床比较

Levobupivacaine 0.75% vs. lidocaine 4% for topical anaesthesia: a clinical comparison in cataract surgery.

作者信息

Di Donato A, Fontana C, Lancia F, Di Giorgio K, Reali S, Caricati A

机构信息

Concordia Hospital for Special Surgery, Department of Anesthesia, Resuscitation and Pain Management, Rome, Italy.

出版信息

Eur J Anaesthesiol. 2007 May;24(5):438-40. doi: 10.1017/S0265021506002018. Epub 2007 Jan 4.

Abstract

BACKGROUND

The aim of this study was to compare the efficacy of topical levobupivacaine drops 0.75% vs. lidocaine drops 4% in cataract surgery.

METHODS

We examined 203 patients undergoing cataract surgery by phacoemulsification. They were randomized into two groups: one received four drops of lidocaine 4% and the other received four drops of levobupivacaine 0.75%. The onset and offset times of sensory block were evaluated. Application, intraoperative and postoperative subjective pain was quantified by the patients using a verbal pain score. Complications, rates of supplemental anaesthesia, and the satisfaction of surgeon and patients were also recorded.

RESULTS

The mean sensory onset and offset times were significantly higher for the levobupivacaine group (P < 0.01). Pain score was lower in the levobupivacaine group than in the lidocaine one and the difference was statistically significant at all stages (P < 0.01). The mean satisfaction scores of patients and surgeon were also statistically higher for levobupivacaine (P < 0.01). No significant differences for complications and rates of supplemental anaesthesia were found.

CONCLUSIONS

Topical levobupivacaine 0.75% shows the same efficacy and safety as lidocaine 4% in cataract surgery by phacoemulsification. There was an adequate block with a good level of satisfaction of surgeon and patients. Levobupivacaine 0.75% offers a new and acceptable choice for topical anaesthesia in cataract surgery.

摘要

背景

本研究旨在比较0.75%左旋布比卡因滴眼液与4%利多卡因滴眼液在白内障手术中的疗效。

方法

我们检查了203例行超声乳化白内障手术的患者。他们被随机分为两组:一组接受4滴4%利多卡因,另一组接受4滴0.75%左旋布比卡因。评估感觉阻滞的起效和消退时间。患者使用语言疼痛评分对用药时、术中及术后的主观疼痛进行量化。记录并发症、追加麻醉率以及外科医生和患者的满意度。

结果

左旋布比卡因组的平均感觉起效和消退时间明显更长(P < 0.01)。左旋布比卡因组的疼痛评分低于利多卡因组,且在所有阶段差异均有统计学意义(P < 0.01)。左旋布比卡因组患者和外科医生的平均满意度评分在统计学上也更高(P < 0.01)。并发症和追加麻醉率方面未发现显著差异。

结论

在超声乳化白内障手术中,0.75%左旋布比卡因滴眼液与4%利多卡因滴眼液具有相同的疗效和安全性。感觉阻滞充分,外科医生和患者满意度良好。0.75%左旋布比卡因滴眼液为白内障手术的表面麻醉提供了一种新的且可接受的选择。

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