Davis P L, O'Connor J P
Department of Ophthalmology, Royal Victoria Hospital, Montreal.
Can J Ophthalmol. 1989 Jun;24(4):155-8.
We carried out a prospective double-blind study to compare the effectiveness of 2% lidocaine hydrocarbonate (54 patients) and 2% lidocaine hydrochloride plus 0.5% bupivacaine hydrochloride (46 patients) in achieving peribulbar block of the orbit in patients undergoing cataract surgery. A total of 150 IU of hyaluronidase was added to each syringe before injection. Anesthesia was done with a total of 6 mL injected into the periphery of the orbit and a further 3 to 4 mL injected for seventh cranial nerve block. A successful block, defined as akinesis of the globe at 4 minutes after injection, was achieved in 94% of the patients, with no difference between the two groups. Two minor complications (transient lateral rectus paresis and a small retrobulbar hematoma) were observed. We recommend this method of peribulbar block as it has a rapid onset and its use may lead to a reduced occurrence of the central nervous system complications associated with retrobulbar block.
我们开展了一项前瞻性双盲研究，比较2%碳酸利多卡因（54例患者）和2%盐酸利多卡因加0.5%盐酸布比卡因（46例患者）在白内障手术患者中实现球周阻滞的有效性。注射前，每个注射器中均加入150 IU透明质酸酶。麻醉时，总共向眼眶周围注射6 mL，再注射3至4 mL用于第七颅神经阻滞。定义为注射后4分钟眼球运动不能的成功阻滞在94%的患者中实现，两组之间无差异。观察到2例轻微并发症（短暂性外直肌麻痹和小的球后血肿）。我们推荐这种球周阻滞方法，因为它起效迅速，使用它可能会减少与球后阻滞相关的中枢神经系统并发症的发生。
