Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, United Kingdom.
J Cataract Refract Surg. 2010 Feb;36(2):286-9. doi: 10.1016/j.jcrs.2009.08.034.
To evaluate 2 local dilution protocols to assess the accuracy and variability of intracameral antibiotic dosage in cataract surgery.
Tennent Institute of Ophthalmology, Glasgow, United Kingdom.
Ten ophthalmic operating room nurses from 2 local hospitals participated. Oven-dried analytical grade potassium chloride (KCl) was used as a surrogate for cefuroxime. Solutions intended for intracameral use (1.0 mg in 0.1 mL) were prepared according to the 2 protocols. Twenty samples were obtained for each protocol. Ten analytical chemists also performed both dilutions. Concentrations of KCl in each 0.1 mL sample were analyzed by flame photometry.
Thirty samples were obtained for each protocol. The median dose after dilution was 1.17 mg (range 0.62 to 1.77 mg) for protocol 1 and 2.05 mg (range 0.52 to 7.25 mg) for protocol 2. The median was significantly higher for protocol 2 (P < .001). There was also greater variability with protocol 2.
This study shows that the mathematical accuracy of a dilution protocol does not ensure dosage accuracy in the clinical scenario. Inadequate mixing in a 1.0 mL syringe was probably responsible for the inaccuracy of protocol 2, indicating that small-volume syringes should not be used for mixing. However, protocol 1 had an acceptable range of variability. Replication of this study could evaluate other protocols and address concerns regarding the accuracy of intracameral antibiotic preparations.
评估 2 种局部稀释方案，以评估白内障手术中腔内抗生素剂量的准确性和变异性。
英国格拉斯哥 Tennent 眼科研究所。
2 家当地医院的 10 名眼科手术室护士参与了这项研究。烤箱干燥的分析级氯化钾 (KCl) 被用作头孢呋辛的替代品。根据 2 种方案制备用于腔内使用的溶液（1.0mg 于 0.1mL 中）。每种方案各获得 20 个样本。10 名分析化学家也对这两种稀释方法进行了操作。每个 0.1mL 样本中的 KCl 浓度通过火焰光度法进行分析。
每种方案各获得 30 个样本。稀释后剂量的中位数为方案 1 为 1.17mg（范围为 0.62 至 1.77mg），方案 2 为 2.05mg（范围为 0.52 至 7.25mg）。方案 2 的中位数明显更高（P<.001）。方案 2 的变异性也更大。
本研究表明，稀释方案的数学准确性并不能确保临床情况下的剂量准确性。在 1.0mL 注射器中混合不充分可能是方案 2 不准确的原因，这表明不应使用小容量注射器进行混合。然而，方案 1 具有可接受的变异性范围。复制这项研究可以评估其他方案，并解决对腔内抗生素制剂准确性的担忧。
