Chen Xiaohong, Liu Bingqian, Liang Xiaoling, Li Jiaqing, Li Tao, Li Yonghao, Yu Xiling, Lyu Cancan, Zhao Xiujuan, Tanumiharjo Silvia, Jin Chenjin, Lu Lin
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
J Ophthalmol. 2017;2017:3464693. doi: 10.1155/2017/3464693. Epub 2017 Jul 9.
This study aims to evaluate the efficacy of ketorolac with local anesthesia compared to local anesthesia alone for perioperative pain control in day care retinal detachment surgery. The randomized controlled trial included 59 eyes of 59 participants for retinal detachment surgery who were randomly assigned (1 : 1) into the ketorolac (K) group and control (C) group. All participants underwent conventional local anesthesia while patients in the K group received an extra administration of preoperative ketorolac. Participants in the K group had a statistically significantly lower intraoperative NRS score (median 1.0 versus 3.0, = 0.003), lower postoperative NRS score (median 0 versus 1.0, = 0.035), fewer proportion of rescue analgesic requirement (10% versus 34.5%, = 0.023), and lower incidence of postoperative nausea and vomiting (13.3% versus 41.4%, = 0.015) compared to the C group. Intraocular pressure (IOP) changes (△IOP) were significantly reduced in the K group (median 1.9 versus 3.0, = 0.038) compared to the C group 24 hours postoperatively. In conclusion, the combination of local anesthesia with ketorolac provides better pain control in retinal detachment surgery compared to local anesthesia alone. The beneficial effect of ketorolac with local anesthesia may contribute to a wider-spread adoption of day care retinal detachment surgery. This trial is registered with ClinicalTrials.gov NCT02729285.
本研究旨在评估酮咯酸联合局部麻醉与单纯局部麻醉相比，在日间视网膜脱离手术围手术期疼痛控制中的疗效。这项随机对照试验纳入了59例接受视网膜脱离手术的参与者的59只眼，这些参与者被随机（1∶1）分为酮咯酸（K）组和对照组（C）。所有参与者均接受传统局部麻醉，而K组患者在术前额外给予酮咯酸。与C组相比，K组参与者的术中数字评分法（NRS）得分在统计学上显著更低（中位数1.0对3.0，P = 0.003），术后NRS得分更低（中位数0对1.0，P = 0.035），需要补救性镇痛的比例更低（10%对34.5%，P = 0.023），术后恶心和呕吐的发生率更低（13.3%对41.4%，P = 0.015）。术后24小时，与C组相比，K组的眼压（IOP）变化（△IOP）显著降低（中位数1.9对3.0，P = 0.038）。总之，与单纯局部麻醉相比，局部麻醉联合酮咯酸在视网膜脱离手术中能提供更好的疼痛控制。酮咯酸联合局部麻醉的有益效果可能有助于日间视网膜脱离手术更广泛地应用。本试验已在ClinicalTrials.gov注册，注册号为NCT02729285。
