Dehghani Alireza, Montazeri Kamran, Masjedi Amin, Karbasi Najmeh, Ashrafi Leila, Saeedian Behrooz
Isfahan University of Medical Sciences, Isfahan, Iran.
J Ophthalmic Vis Res. 2011 Jul;6(3):177-82.
To evaluate the effect of local lidocaine application on the incidence of the oculocardiac reflex (OCR) during scleral buckling (SB) for rhegmatogenous retinal detachment (RRD) under general anesthesia.
In a randomized clinical trial, eyes with RRD scheduled for SB under general anesthesia were randomized to adjunctive local application of 1 ml lidocaine 2% versus normal saline to the muscles after conjunctival opening. Surgical stimulation was initiated 5 minutes afterwards. Additionally, 100 mg of lidocaine 2% was added to 50 ml of normal saline in the treatment group which was used for irrigation during surgery; control eyes were irrigated with normal saline. The incidence of the OCR, rate of postoperative nausea/vomiting (PONV), total intravenous (IV) analgesic dose, duration of surgery, and period of hospitalization were compared between the study groups.
Thirty eyes of 30 patients including 22 (73.3%) male and 8 (26.7%) subjects with mean age of 49.4±16.3 years were operated. OCR and PONV occurred less frequently, and total intravenous analgesic dose was significantly lower in the lidocaine group (P < 0.05 for all comparisons). However, no significant difference was noted between the study groups in terms of duration of surgery and period of hospitalization.
Adjunctive local application of lidocaine during SB under GA for RRD decreases the rate of OCR and PONV, reduces the intravenous analgesic dose, but does not affect the duration of surgery or hospitalization.
评估在全身麻醉下，局部应用利多卡因对孔源性视网膜脱离（RRD）巩膜扣带术（SB）期间眼心反射（OCR）发生率的影响。
在一项随机临床试验中，计划在全身麻醉下进行SB的RRD患者的眼睛，在结膜切开后随机分为两组，一组在肌肉局部应用1 ml 2%利多卡因，另一组应用生理盐水。5分钟后开始手术刺激。此外，治疗组在50 ml生理盐水中加入100 mg 2%利多卡因用于术中冲洗；对照组用生理盐水冲洗。比较研究组之间OCR的发生率、术后恶心/呕吐（PONV）发生率、静脉镇痛总剂量、手术时间和住院时间。
对30例患者的30只眼进行了手术，其中男性22例（73.3%），女性8例（26.7%），平均年龄49.4±16.3岁。利多卡因组OCR和PONV的发生率较低，静脉镇痛总剂量显著较低（所有比较P<0.05）。然而，研究组之间在手术时间和住院时间方面没有显著差异。
全身麻醉下RRD行SB时局部应用利多卡因可降低OCR和PONV的发生率，减少静脉镇痛剂量，但不影响手术时间或住院时间。
