Hessemer V, Hoppe O, Jacobi K W
Universitäts-Augenklinik, Giessen, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1991;88(2):196-200.
Twenty patients had retrobulbar anesthesia with 5 ml mepivacaine (Scandicain) without or with addition of 150 units of hyaluronidase (Kinetin). Before and 15 min after injection, we determined--by means of oculo-oscillo-dynamography--the systolic retinal and ciliary perfusion pressures, the respective ocular blood pressures (intramural pressures) and the ocular pulsation volume (PVoc) as well as the intraocular pressure (Pio; hand-applanation tonometer). Without hyaluronidase, the ocular perfusion and blood pressures were lowered by 11.8 and 3.9 mmHg, respectively, and PVoc was reduced by 0,40 microliters, whereas Pio was increased by 7.9 mmHg With hyaluronidase, the ocular perfusion and blood pressures were decreased by averages of 12.7 and 6.8 mmHg, respectively, PVoc was reduced by 0.42 microliters, and Pio was increased by 6.0 mmHg. Within each group, all changes were significant. There were, however, no significant differences between the two groups, i.e., the "spreading factor" hyaluronidase does not influence the inhibitory effects of retrobulbar anesthesia on ocular circulation.
20例患者接受球后麻醉,使用5毫升甲哌卡因(斯康杜尼),不加或加用150单位透明质酸酶(激肽释放酶)。在注射前及注射后15分钟,我们通过眼震动力描记法测定视网膜和睫状动脉收缩期灌注压、各自的眼内压(壁内压)和眼脉动容积(PVoc)以及眼压(Pio;手持压平眼压计)。未加透明质酸酶时,眼灌注压和血压分别降低11.8和3.9 mmHg,PVoc减少0.40微升,而Pio升高7.9 mmHg。加用透明质酸酶时,眼灌注压和血压平均分别降低12.7和6.8 mmHg,PVoc减少0.42微升,Pio升高6.0 mmHg。每组内所有变化均有统计学意义。然而,两组之间无显著差异,即“扩散因子”透明质酸酶不影响球后麻醉对眼循环的抑制作用。