Sajedi Parvin, Nejad Maryam Soleymani, Montazeri Kamran, Baloochestani Elahe
Department of Anesthesia and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2013 Nov;4(11):1258-65.
The current study aimed to determine preventive effect of 2 percent topical xylocaine on oculocardiac reflex in ophthalmological surgeries except strabismus, including retinal detachment and vitrectomy with scleral buckling under general anesthesia.
A randomized controlled clinical trial was carried out on 150 patients aged 18-90 years undergoing ophthalmological surgeries under general anesthesia. Samples randomly divided into the experimental group (received four drops of 2 percent topical xylocaine instilled in desired eye) and control group (received 0.5 mg atropine sulfate injection). Systolic, diastolic and mean arterial blood pressure of patients and baseline heart rate were recorded. They were compared regarding the incidence of bradycardia, heart rate less than 60 beats/minute, hypotension and blood pressure less than 90 mm/Hg. Data were analyzed by Statistical Package for the Social Sciences software version 20 using Chi-square and ANOVA.
The difference between two groups was not statistically significant regarding demographic and basic variables. The incidence of bradycardia in both groups was respectively (90.7 percent vs. 17.3 percent), heart rate less than 60 beats/minute (40 percent vs. 13.3 percent), hypotension (76 percent vs. 32 percent) and blood pressure less than 90 mmHg was (28 percent vs. 8 percent). Accordingly, the differences between both groups were statistically significant (P > 0.001).
The preventive impact of topical xylocaine upon oculocardiac reflex in ophthalmological surgeries such as retinal detachment and vitrectomy with scleral buckling under general anesthesia was less effective than that of atropine injection. Therefore, to avoid this reflex in high-risk patients, injecting atropine would be safer.
本研究旨在确定2%的局部用利多卡因对除斜视外的眼科手术（包括视网膜脱离和全身麻醉下巩膜扣带术的玻璃体切除术）中眼心反射的预防效果。
对150例年龄在18 - 90岁、接受全身麻醉的眼科手术患者进行了一项随机对照临床试验。样本被随机分为实验组（在所期望的眼睛中滴入四滴2%的局部用利多卡因）和对照组（接受0.5毫克硫酸阿托品注射）。记录患者的收缩压、舒张压和平均动脉血压以及基线心率。比较两组患者心动过缓（心率低于60次/分钟）、低血压（血压低于90毫米汞柱）的发生率。使用社会科学统计软件包20版通过卡方检验和方差分析对数据进行分析。
两组在人口统计学和基本变量方面的差异无统计学意义。两组心动过缓的发生率分别为（90.7%对17.3%），心率低于60次/分钟的发生率分别为（40%对13.3%），低血压发生率分别为（76%对32%），血压低于90毫米汞柱的发生率分别为（28%对8%）。因此，两组之间的差异具有统计学意义（P < 0.001）。
在全身麻醉下的视网膜脱离和巩膜扣带术的玻璃体切除术等眼科手术中，局部用利多卡因对眼心反射的预防作用不如阿托品注射有效。因此，为避免高危患者出现这种反射，注射阿托品会更安全。
