Joshi Rajesh Subhash
Department of Ophthalmology, Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, India.
Middle East Afr J Ophthalmol. 2017 Jul-Sep;24(3):126-130. doi: 10.4103/meajo.MEAJO_68_17.
This study aims to evaluate the efficacy of lignocaine 2% jelly as a topical anesthesia in recurrent pterygium surgery with glue-free conjunctival limbal autograft.
A prospective, nonrandomized, observational study, comprising of 51 patients (51 eyes) having recurrent pterygium, was conducted at a tertiary eye care center in central India. Pterygium excision with glue-free autologous conjunctival grafting was done under 2% lignocaine jelly. The visual analog scale was utilized to record the intra- and post-operative pain score. Patient comfort, intraoperative painful sensations perceived by the patient, supplemental anesthesia, complications, and surgeon discomfort were noted. Anesthetist also noted vital parameters and any intravenous drugs required.
No difference in intra- and post-operative pain score ( = 0.24) was observed in the patients. Zero score, i.e. no pain was noticed in 30 patients (58.8%) patients. The average surgical time was 29.20 min (+1.11). The average surgeon discomfort score was 0.18 + 0.51. Inadvertent eye movement was seen in 3 patients (5.9%). Lid squeeze was noted in 45 patients (88.2%) during placement of lid speculum. Forty-eight patients (94.1%) gave preference to the topical anesthesia of 2% lignocaine jelly compared to the previous mode of anesthesia.
Pterygium surgery with glue-free autogenous conjunctival grafting can be performed successfully by preoperative local application of 2% lignocaine jelly. The ease of application, lack of toxicity and sufficient effect to complete the surgery make it an efficient alternative to injectable anesthetics.
本研究旨在评估2%利多卡因凝胶作为表面麻醉剂在复发性翼状胬肉无胶水结膜角膜缘自体移植手术中的疗效。
在印度中部的一家三级眼科护理中心进行了一项前瞻性、非随机、观察性研究,纳入51例(51只眼)复发性翼状胬肉患者。在2%利多卡因凝胶麻醉下进行无胶水自体结膜移植翼状胬肉切除术。采用视觉模拟量表记录术中和术后疼痛评分。记录患者舒适度、患者术中感知的疼痛感觉、补充麻醉、并发症和外科医生的不适感。麻醉师还记录了生命体征参数以及所需的任何静脉药物。
患者的术中和术后疼痛评分无差异( = 0.24)。30例(58.8%)患者疼痛评分为零分,即无疼痛。平均手术时间为29.20分钟(±1.11)。外科医生的平均不适评分为0.18 ± 0.51。3例(5.9%)患者出现术中眼球意外移动。放置开睑器时,45例(88.2%)患者出现眼睑挤压。与之前的麻醉方式相比,48例(94.1%)患者更倾向于2%利多卡因凝胶表面麻醉。
术前局部应用2%利多卡因凝胶可成功进行无胶水自体结膜移植翼状胬肉手术。其应用简便、无毒且足以完成手术,使其成为注射麻醉剂的有效替代方法。