Godarzi Mehrdad, Beyranvand Siyavash, Arbabi Shahriar, Sharoughi Mehrdad, Mohtaram Robab, Soltani Alireza Ebrahim
Department of Anesthesiology, Children Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2011;49(8):509-12.
Peribulbar anesthesia is widely applied in cataract surgeries. The aim of this study was comparing the effect of using Atracourium, cis-Atracourium, and placebo as adjuvant agents to the local anesthetic substance on peribulbar-induced akinesia in cataract surgeries. The study was double-blind randomized clinical trial, among the patients candidate for the cataract surgery who were hospitalized in ocular surgery ward in Farabi Hospital between 2006 and 2007. 90 patients were subcategorized into 3 groups randomly. Group I received a mixture (8 ml) containing equal parts of Marcaine 0.5%, Lidocaine 2% and Hyaluronidase 90 IU plus 0.5 ml normal saline; group II received the mixture (8 ml) plus 0.5 ml Atracourium 5 mg, and group III received the mixture (8 ml) plus 0.5 ml cis-Atracurium with the help of peribulbar blockage technique. The score of akinesia were evaluated in the 1st, 3rd, 5th, 10th minutes after administration of the medications. 10 minute after drug administration, 25 (92.6%) reached the total akinesia with Atracourium, 23 (85.2%) with cis-Atracourium, and 23 (85.2%) with the placebo (P>0.05). Addition of low-dose Atracourium and cis-Atracourium to the anesthetic drug is recommended in order to accelerate the onset of akinesia resulted by the peribulbar block, and in order to enhance the quality of akinesia especially when Hyaloronidaze is not added.
球周麻醉在白内障手术中广泛应用。本研究的目的是比较使用阿曲库铵、顺式阿曲库铵和安慰剂作为局部麻醉药辅助剂对白内障手术中球周诱导的运动不能的影响。该研究为双盲随机临床试验，研究对象为2006年至2007年在法拉比医院眼科病房住院的白内障手术候选患者。90名患者被随机分为3组。第一组接受一种混合液（8毫升），其中含等量的0.5%布比卡因、2%利多卡因和90国际单位透明质酸酶加0.5毫升生理盐水；第二组接受该混合液（8毫升）加0.5毫升5毫克阿曲库铵，第三组在球周阻滞技术辅助下接受该混合液（8毫升）加0.5毫升顺式阿曲库铵。在用药后第1、3、5、10分钟评估运动不能评分。用药10分钟后，使用阿曲库铵的患者中有25例（92.6%）达到完全运动不能，使用顺式阿曲库铵的有23例（85.2%），使用安慰剂的有23例（85.2%）（P>0.05）。建议在麻醉药中添加低剂量阿曲库铵和顺式阿曲库铵，以加速球周阻滞导致的运动不能的起效，并提高运动不能的质量，尤其是在不添加透明质酸酶的情况下。
