Mason John O, Goodwin Peter L, Feist Richard M, Vail Rachel S
Department of Ophthalmology, University of Alabama at Birmingham School of Medicine, Callahan Eye Foundation Hospital, USA.
Ophthalmic Surg Lasers Imaging. 2007 May-Jun;38(3):203-8. doi: 10.3928/15428877-20070501-04.
To determine whether irrigation of the sub-Tenon's space with anesthetic agents during pars plana vitrectomy (PPV) involving general anesthesia decreases postoperative pain, analgesic use, or nausea.
A prospective, controlled trial of 46 consecutive patients requesting general anesthesia for PPV who were randomized to receive or not receive a sub-Tenon's space injection prior to surgery. A mixture of 3 mL of 2% lidocaine with hyaluronidase and 3 mL of 0.5% bupivacaine was used to induce local blockade. Pain, postoperative nausea, and analgesia use were evaluated.
Local blockade did not significantly alter the proportion of reported pain at 30 minutes and 2, 4, and 24 hours after the operation. The local blockade had no effect on reducing postoperative nausea or the number of patients requiring pain medication.
Local blockade prior to surgery in patients undergoing PPV under general anesthesia does not significantly decrease postoperative pain, analgesic use, or nausea.
确定在全身麻醉下进行的玻璃体切除术（PPV）中，向眼球筋膜下间隙注射麻醉剂是否能减轻术后疼痛、减少镇痛药物使用或降低恶心发生率。
一项前瞻性对照试验，纳入46例连续要求全身麻醉下进行PPV的患者，随机分为术前接受或不接受眼球筋膜下间隙注射组。使用3毫升含透明质酸酶的2%利多卡因与3毫升0.5%布比卡因混合液进行局部阻滞。评估疼痛、术后恶心及镇痛药物使用情况。
局部阻滞并未显著改变术后30分钟、2小时、4小时及24小时报告疼痛的患者比例。局部阻滞对减轻术后恶心或减少需要使用止痛药物的患者数量没有效果。
全身麻醉下接受PPV的患者术前进行局部阻滞并不能显著减轻术后疼痛、减少镇痛药物使用或降低恶心发生率。
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