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尼日利亚人白内障手术中球周麻醉与后Tenon囊下麻醉的比较。

Comparison of Peribulbar with Posterior Sub-Tenon's Anesthesia in Cataract Surgery Among Nigerians.

作者信息

Iganga Ogbonnaya N, Fasina Oluyemi, Bekibele Charles O, Ajayi Benedictus G K, Ogundipe Ayobade O

机构信息

Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.

Department of Ophthalmology, University of Ibadan/University College Hospital, Ibadan, Nigeria.

出版信息

Middle East Afr J Ophthalmol. 2016 Apr-Jun;23(2):195-200. doi: 10.4103/0974-9233.164609.

Abstract

PURPOSE

To compare the akinetic and the analgesic effects of peribulbar and posterior sub-Tenon's anesthesia in patients undergoing cataract surgery.

METHODS

In a hospital-based randomized comparative interventional study, patients aged 50 years and above who underwent elective surgery for uncomplicated cataract were randomized to receive either peribulbar block or posterior sub-Tenon block. Pain during injection, surgery, and after surgery was assessed using numerical reporting scale (NRS). Limbal excursion was measured with a transparent meter rule.

RESULT

A total of 152 eyes of 152 patients were studied. Peribulbar and sub-Tenon regional blocks provided comparable adequate akinesia (P = 0.06) and similar levels of analgesia (P = 0.10) during cataract surgery. Both techniques also provided similar levels of analgesia to the patient during injection and in the immediate postoperative period. Ninety-two percent of patients who had peribulbar and 97% of those who had sub-Tenon blocks reported either mild pain or no pain at all during surgery (P = 0.49). There was no report of severe pain in all patients during the stages of the surgery. Occurrence of chemosis and subconjunctival hemorrhage was more common in sub-Tenon than peribulbar anesthesia.

CONCLUSIONS

This study shows that peribulbar and posterior sub-Tenon routes of administering anesthetic substances is comparable in providing adequate akinesia and analgesia for cataract surgery with minimal complications. Therefore, both techniques are effective and safe for cataract surgery among Nigerians.

摘要

目的

比较球周麻醉和Tenon囊下麻醉对白内障手术患者的制动和镇痛效果。

方法

在一项基于医院的随机对照干预性研究中,年龄50岁及以上接受择期单纯性白内障手术的患者被随机分为接受球周阻滞或Tenon囊下阻滞。使用数字报告量表(NRS)评估注射、手术中和手术后的疼痛。用透明米尺测量角膜缘移动度。

结果

共研究了152例患者的152只眼。球周阻滞和Tenon囊下区域阻滞在白内障手术期间提供了相当的充分制动效果(P = 0.06)和相似的镇痛水平(P = 0.10)。两种技术在注射期间和术后即刻也为患者提供了相似的镇痛水平。92%接受球周阻滞的患者和97%接受Tenon囊下阻滞的患者在手术期间报告轻度疼痛或无疼痛(P = 0.49)。在手术各阶段所有患者均未报告严重疼痛。Tenon囊下麻醉结膜水肿和结膜下出血的发生率比球周麻醉更常见。

结论

本研究表明,球周和Tenon囊下注射麻醉药物途径在为白内障手术提供充分制动和镇痛且并发症最少方面具有可比性。因此,这两种技术对尼日利亚白内障手术患者都是有效且安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bac/4845618/5df1cf7c1898/MEAJO-23-195-g001.jpg

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