Erdurmus M, Aydin B, Usta B, Yagci R, Gozdemir M, Totan Y
Department of Ophthalmology, Fatih University Medical School, Ankara - Turkey.
Eur J Ophthalmol. 2008 May-Jun;18(3):361-7. doi: 10.1177/112067210801800308.
To determine the safety and efficacy of perioperative dexmedetomidine (Dex) sedation on patient comfort and surgeon satisfaction during cataract surgery under topical anesthesia.
Forty-four patients having routine clear corneal phacoemulsification surgery under topical anesthesia were included in the study. Patients were randomly divided into two groups: Dex group (n=22) and control group (n=22). Patients in the Dex group were to receive intravenous Dex using an infusion pump and those in the control group were to receive 0.9% saline infusion. Primary outcome measures were patient comfort, surgeon satisfaction, and patient pain perception.
There was no significant difference between the groups in terms of baseline characteristics including age, sex, eye side, pupil diameter, and vital signs (p>0.05 for all). Patient comfort and surgeon satisfaction in Dex group was better than in control group (p=0.042 and p=0.003, respectively). The mean pain perception score was lesser in the Dex group (1.23+-.72) than control group (3.64+/-1.43), (p<0.001). The mean surgical time and intraoperative complications were similar in both groups (p>0.05). There was no significant effect of the Dex sedation on vital signs perioperatively (p>0.05 for all).
Dex sedation improved patient and surgeon satisfaction and decreased patients' pain perception while undergoing cataract surgery under topical anesthesia. It appears to be a safe and suitable choice of sedation for cataract surgery.
确定围手术期右美托咪定(Dex)镇静在表面麻醉下白内障手术中对患者舒适度和外科医生满意度的安全性和有效性。
本研究纳入44例行表面麻醉下常规透明角膜超声乳化手术的患者。患者随机分为两组:Dex组(n = 22)和对照组(n = 22)。Dex组患者使用输液泵静脉输注Dex,对照组患者输注0.9%生理盐水。主要观察指标为患者舒适度、外科医生满意度和患者疼痛感知。
两组患者在年龄、性别、患眼侧别、瞳孔直径和生命体征等基线特征方面无显著差异(所有p>0.05)。Dex组患者的舒适度和外科医生满意度均优于对照组(分别为p = 0.042和p = 0.003)。Dex组的平均疼痛感知评分(1.23±0.72)低于对照组(3.64±1.43),(p<0.001)。两组的平均手术时间和术中并发症相似(p>0.05)。Dex镇静对围手术期生命体征无显著影响(所有p>0.05)。
Dex镇静可提高表面麻醉下白内障手术患者及外科医生的满意度,并降低患者的疼痛感知。它似乎是白内障手术中一种安全且合适的镇静选择。