Anaraki Abdolreza Najafi, Akrami Abbas, Motamed Niloofar, Seydali Elham
Department of Anesthesiology, Bushehr University of Medical Sciences, Bushehr, Iran.
Saudi J Anaesth. 2012 Jul;6(3):268-72. doi: 10.4103/1658-354X.101220.
Despite several recent innovations in phacoemulsification surgery, importance of pupil diameter in this surgery is becoming more evident.
To compare the effect of opioid agonist (fentanyl) versus opioid agonist-antagonist (buprenorphine) on pupil diameter in cataract surgery and to choose the best opioid in high-risk phacoemulsification surgery.
In this randomized double-blinded clinical trial, 60 patients who were candidates for elective phacoemulsification surgery were randomly divided into two equal groups: experimental (buprenorphine, 0.3 μg/kg) and control (fentanyl, 1 μg/kg). Pupil diameter was measured preinjection and at several times postinjection. Blood pressure was recorded at several intervals, as well as shivering, nausea and vomiting, and recovery time.
Mean (SD) recovery time was significantly less in the control group (19.46±5.43) than in the experimental group (33.23±10.75) (P<0.0001). The constriction effect (ie, pupillary diameter in mm) was significantly lower in the experimental group (0.53±0.45) than in the control group (1.06±0.52) (P=0.0001). The percentages of constriction effect in experimentaland control groups were 7.68% and 15.07%, respectively. The eye was two times more constricted in the control group in comparison with the experimental group after induction of anesthesia.
Buprenorphine is a better solution to decrease pupil constriction in comparison with fentanylinhigh-risk phacoemulsification surgery.
尽管近年来白内障超声乳化手术有多项创新，但瞳孔直径在该手术中的重要性日益凸显。
比较阿片类激动剂（芬太尼）与阿片类激动剂 - 拮抗剂（丁丙诺啡）对白内障手术中瞳孔直径的影响，并在高危超声乳化手术中选择最佳阿片类药物。
在这项随机双盲临床试验中，60例择期白内障超声乳化手术患者被随机分为两组：实验组（丁丙诺啡，0.3μg/kg）和对照组（芬太尼，1μg/kg）。在注射前及注射后多次测量瞳孔直径。在多个时间点记录血压、寒战、恶心呕吐及恢复时间。
对照组的平均（标准差）恢复时间（19.46±5.43）显著短于实验组（33.23±10.75）（P<0.0001）。实验组的缩瞳效果（即瞳孔直径，单位为mm）（0.53±0.45）显著低于对照组（1.06±0.52）（P=0.0001）。实验组和对照组的缩瞳效果百分比分别为7.68%和15.07%。麻醉诱导后，对照组眼睛的缩瞳程度是实验组的两倍。
在高危超声乳化手术中，与芬太尼相比，丁丙诺啡是减少瞳孔收缩的更好选择。
