Etesse B, Beaudroit L, Deleuze M, Nouvellon E, Ripart J
Pôle Anesthésie-Douleur-urgences-Réanimation, Groupe Hospitalo-Universitaire Carémeau, 30029 Nîmes cedex 09, France.
Ann Fr Anesth Reanim. 2009 Jul-Aug;28(7-8):658-65. doi: 10.1016/j.annfar.2009.05.013. Epub 2009 Jul 3.
To summarize the benefits and lateral effects of hyaluronidase (H) use in ophthalmologic anaesthesia and to address its unavailability in current practice in France.
The Medline data bank and the Cochrane database were consulted. The keywords employed separately or in combination were: H, regional anaesthesia, ophthalmologic surgery, local aneasthetics myotoxicity, diplopia.
Original articles since 1949 were selected. We also selected isolated clinical cases according to their relevance compared with the existing literature.
H is a "spreading factor" of animal origin used as an adjuvant in ophthalmic anaesthesia for more than half a century. It allows a moderate better block quality with a slightly quicker onset. It also limits the acute intraocular pressure increase secondary to periocular injection and seems to have a protective effect against local anaesthetics myotoxicity resulting in postoperative strabismus. However, during these last 50 years, numerous studies often ended in divergent results.
H seems to be a useful adjuvant in ophthalmologic anaesthesia in spite of his current unavailability in France. Recombinant H could be the solution in the near future.
总结透明质酸酶（H）在眼科麻醉中的益处和副作用，并探讨其在法国当前临床实践中无法获取的问题。
查阅了Medline数据库和Cochrane数据库。单独或组合使用的关键词有：H、区域麻醉、眼科手术、局部麻醉药的肌毒性、复视。
选取了1949年以来的原始文章。我们还根据与现有文献的相关性选择了孤立的临床病例。
H是一种动物源性的“扩散因子”，作为辅助剂用于眼科麻醉已有半个多世纪。它能使阻滞质量适度提高，起效稍快。它还能限制眼周注射继发的急性眼压升高，似乎对局部麻醉药的肌毒性有保护作用，从而预防术后斜视。然而，在过去50年里，众多研究结果往往相互矛盾。
尽管目前在法国无法获取H，但它似乎是眼科麻醉中一种有用的辅助剂。重组H可能是不久将来的解决方案。
