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农村眼科义诊活动中白内障囊外摘除术的联合深层局部及球结膜下浸润麻醉

Combined deep topical and superior subconjunctival anesthesia for extracapsular cataract extraction in a rural eye camp.

作者信息

Tinnungwattana Uraiwan, Gorvanich Suchaya, Kulvichit Kittisak, Tulvatana Wasee

机构信息

Relief Division, Relief and Community Health Bureau,Thai Red Cross Society, Bangkok, Thailand.

出版信息

Anesth Analg. 2009 Dec;109(6):2025-7. doi: 10.1213/ANE.0b013e3181be0da7.

Abstract

BACKGROUND

Anesthesia for cataract surgery at eye camps needs to be simple, safe, and effective.

METHODS

We prospectively studied 98 patients undergoing cataract extraction in a rural eye camp in Thailand. Patients undergoing extracapsular cataract extraction with intraocular lens implantation (ECCE/IOL) received deep topical anesthesia with subconjunctival anesthesia. Patients undergoing phacoemulsification with intraocular lens implantation (Phaco/IOL) received topical anesthesia. Pain visual analog score, operative and anesthetic complications, operative time, and additional medications were recorded.

RESULTS

A mean age of 68.7 vs 67.5 yr, an operative time of 16.1 +/- 6.7 min vs 12.0 +/- 4.7 min, and a median (interquartile range) pain score of 30.5 mm (12.3-54.6 mm) vs 20.0 mm (9.0-45.9 mm) were seen in the ECCE/IOL and Phaco/IOL groups, respectively. Three cases of ruptured posterior capsule occurred in the Phaco/IOL group. No additional anesthesia was needed. No anesthetic complications occurred.

CONCLUSION

In a rural eye camp, deep topical anesthesia with subconjunctival anesthesia for ECCE/IOL and topical anesthesia for Phaco/IOL provide effective anesthesia for cataract surgery.

摘要

背景

在眼科义诊营地进行白内障手术的麻醉需要简单、安全且有效。

方法

我们前瞻性地研究了泰国一个农村眼科义诊营地中98例接受白内障摘除术的患者。接受囊外白内障摘除联合人工晶状体植入术(ECCE/IOL)的患者接受结膜下深层表面麻醉。接受超声乳化白内障吸除联合人工晶状体植入术(Phaco/IOL)的患者接受表面麻醉。记录疼痛视觉模拟评分、手术和麻醉并发症、手术时间及额外用药情况。

结果

ECCE/IOL组和Phaco/IOL组的平均年龄分别为68.7岁和67.5岁,手术时间分别为16.1±6.7分钟和12.0±4.7分钟,疼痛评分中位数(四分位间距)分别为30.5毫米(12.3 - 54.6毫米)和20.0毫米(9.0 - 45.9毫米)。Phaco/IOL组发生3例后囊破裂。无需追加麻醉。未发生麻醉并发症。

结论

在农村眼科义诊营地,ECCE/IOL采用结膜下深层表面麻醉,Phaco/IOL采用表面麻醉,可为白内障手术提供有效的麻醉。

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