Yuen J S, Prineas S, Pham T, Liu H
Orana Eye Centre, Dubbo Private Hospital, Dubbo, New South Wales, Australia.
Anaesth Intensive Care. 2007 Dec;35(6):945-8. doi: 10.1177/0310057X0703500614.
This study compared the efficacy of two different injection sites for subconjunctival anaesthesia (SCA) in cataract surgery. One-hundred-and-three eyes of 99 consecutive patients undergoing routine cataract surgery were randomised to receive SCA either to the superior bulbar conjunctiva (n = 52) or the inferior bulbar conjunctiva (n = 51). Pain experienced during anaesthetic administration and at various stages of the perioperative period was assessed using a simplified scale. Assessment of subconjunctival haemorrhage and chemosis was made by the surgeon. The percentage of patients reporting any pain on administration of superior SCA was 46% compared to 67% with inferior SCA (P = 0.036). Moderate to severe pain on SCA injection was experienced by 15% and 18% of those in the superior and inferior SCA groups respectively. The cataract procedure was well tolerated in both groups. There was no difference between the groups for duration of surgery (P = 0.25), anaesthetic related complications including chemosis (P = 0.28), subconjunctival haemorrhage (P = 0.38) or intraoperative complications (P = 0.50). We found that subconjunctival anaesthesia is effective for routine cataract surgery. There was no difference in block efficacy between superiorly and inferiorly delivered SCA. However, superior SCA appeared to be less painful on injection compared to inferiorly delivered SCA.
本研究比较了白内障手术中两种不同结膜下麻醉（SCA）注射部位的效果。99例连续接受常规白内障手术的患者的103只眼睛被随机分为两组，分别接受上睑结膜下麻醉（n = 52）或下睑结膜下麻醉（n = 51）。使用简化量表评估麻醉给药期间及围手术期各个阶段的疼痛情况。由外科医生评估结膜下出血和球结膜水肿情况。报告在上睑结膜下麻醉给药时有任何疼痛的患者比例为46%，而下睑结膜下麻醉时为67%（P = 0.036）。上睑结膜下麻醉组和下睑结膜下麻醉组分别有15%和18%的患者在SCA注射时经历中度至重度疼痛。两组对白内障手术的耐受性均良好。两组在手术时长（P = 0.25）、包括球结膜水肿在内的麻醉相关并发症（P = 0.28）、结膜下出血（P = 0.38）或术中并发症（P = 0.50）方面均无差异。我们发现结膜下麻醉对常规白内障手术有效。上睑和下睑结膜下麻醉的阻滞效果无差异。然而，与下睑结膜下麻醉相比，上睑结膜下麻醉注射时似乎疼痛较轻。
