Academic Department of Ophthalmology, Manchester Royal Eye Hospital, Oxford Road, Manchester M13 9WH, UK.
Br J Ophthalmol. 2010 Jan;94(1):28-32. doi: 10.1136/bjo.2008.155572. Epub 2009 Sep 1.
BACKGROUND/AIMS: To devise and evaluate a novel Ocular Anaesthetic Scoring System (OASS) for non-topical local anaesthesia.
In OASS, a score of between 0 (poor) and 14 (excellent) was devised measuring motor (ocular motility, levator and orbicularis function) and sensory functions (digital spear pressure at limbus and topical anaesthetic sting). 40 patients were studied prospectively to analyse interobserver consistency in OASS. A further 100 patients were collected into four groups receiving either sub-Tenon or peribulbar block with 150 or 300 units of hyaluronidase. Patient satisfaction was determined using the Visual Analogue Pain Scale and Iowa Satisfaction with Anaesthesia Scale.
There was no significant difference in OASS scores between two independent observers (p = 0.8910). The sub-Tenon approach achieved significantly better OASS scores than the peribulbar approach (p<0.0004). 300 units of hyaluronidase gave significantly higher OASS scores in both sub-Tenon (p<0.0001) and peribulbar groups (p<0.0001). Spearman rank correlation showed that OASS correlates significantly with VAPS (-0.82, p<0.0001) and ISAS (0.70, p<0.0001). The median satisfaction score was significant in order of magnitude: sub-Tenon with 300 units of hyaluronidase>sub-Tenon with 150 units of hyaluronidase>peribulbar with 300 units of hyaluronidase>peribulbar with 150 units of hyaluronidase.
OASS is a simple and robust system for assessing and comparing non-topical local anaesthetic techniques. Of the techniques evaluated, a sub-Tenon block with 300 units of hyaluronidase gives the best anaesthesia, analgesia and patient satisfaction results.
背景/目的：设计并评估一种新型的眼部麻醉评分系统（OASS），用于非局部表面麻醉。
在 OASS 中，设计了一个 0（差）至 14（优）的评分，用于测量运动（眼球运动、提上睑肌和眼轮匝肌功能）和感觉功能（角膜缘的数字刺针压力和局部麻醉刺痛）。40 名患者前瞻性研究以分析 OASS 中的观察者间一致性。进一步收集了 100 名患者，分为四组，分别接受玻璃体内 Tenon 下或球周阻滞，使用 150 或 300 单位透明质酸酶。使用视觉模拟疼痛量表和爱荷华州麻醉满意度量表来确定患者满意度。
两名独立观察者的 OASS 评分无显著差异（p=0.8910）。玻璃体内 Tenon 下方法的 OASS 评分明显优于球周阻滞方法（p<0.0004）。300 单位透明质酸酶在玻璃体内 Tenon 下（p<0.0001）和球周阻滞组（p<0.0001）中均获得更高的 OASS 评分。Spearman 秩相关显示，OASS 与 VAPS（-0.82，p<0.0001）和 ISAS（0.70，p<0.0001）显著相关。中位数满意度评分按数量级显著：玻璃体内 Tenon 下 300 单位透明质酸酶>玻璃体内 Tenon 下 150 单位透明质酸酶>球周阻滞下 300 单位透明质酸酶>球周阻滞下 150 单位透明质酸酶。
OASS 是一种用于评估和比较非局部表面麻醉技术的简单而可靠的系统。在所评估的技术中，玻璃体内 Tenon 下使用 300 单位透明质酸酶的阻滞效果最佳，可提供最佳的麻醉、镇痛和患者满意度。
