Nagy Ahmed Ahmed, El-Sayd Saber Hamed, Ahmed Ahmed Abdelaziz, Rajab Ghada Zin-Eldin
Shebeen El Kom Hospital, Menoufia, Egypt.
Department of Ophthalmology, Menoufia University, Menoufia, Egypt.
Anesth Essays Res. 2017 Oct-Dec;11(4):1046-1050. doi: 10.4103/aer.AER_116_17.
The cataract surgery anesthesia should be to make the procedure as safe and as satisfactory as possible for all concerned. The recent progress in anesthesia and surgery now allow cataract extraction to be done with minimal physiological changes to the patient. We aimed in the study to compare between two different doses of dexmedetomidine combined with lidocaine and bupivacaine during retrobulbar anesthesia for cataract extraction by phacoemulsification.
This study was done on forty patients with cataract. The patients were enrolled in two groups: Group (A):Twenty patients were received 1.5 ml 2% lidocaine + 1.5 ml 0.5% bupivacaine + 0.25 μg/kg of dexmedetomidine and Group (B): Twenty patients were received 1.5 ml 2% lidocaine + 1.5 ml 0.5% bupivacaine + 0.5 μg/kg of dexmedetomidine.
The globe anesthesia duration, globe, and lid akinesia were significantly longer in the Group B than in the Group A ( < 0.05). Intraocular pressure decreased through the first 15 min after anesthesia in the two groups, and the changes were not significant between the two groups but highly significant in every group when compared to its baseline reading. As regards the conscious level in the two groups, there was a significant difference ( < 0.001). Group A is higher regarding score 2 and 3, and Group B higher in score 4.
We concluded that dexmedetomidine 0.25 μg/kg, when added to retrobulbar block for cataract surgery, will significantly increase the duration of retrobulbar block and improve both the surgeon and the patient satisfaction.
白内障手术麻醉应使该手术对所有相关人员而言尽可能安全且令人满意。麻醉和手术方面的最新进展使得白内障摘除术能够在对患者生理影响最小的情况下进行。我们开展本研究旨在比较两种不同剂量的右美托咪定联合利多卡因和布比卡因用于白内障超声乳化摘除术球后麻醉时的效果。
本研究针对40例白内障患者开展。患者被分为两组：A组：20例患者接受1.5毫升2%利多卡因 + 1.5毫升0.5%布比卡因 + 0.25微克/千克右美托咪定；B组：20例患者接受1.5毫升2%利多卡因 + 1.5毫升0.5%布比卡因 + 0.5微克/千克右美托咪定。
B组的眼球麻醉持续时间、眼球及眼睑运动不能明显长于A组（<0.05）。两组在麻醉后最初15分钟内眼压均下降，两组间变化无显著差异，但与基线读数相比，每组变化均高度显著。关于两组的意识水平，存在显著差异（<０.001）。A组在2分和3分的评分上较高，B组在4分的评分上较高。
我们得出结论，在白内障手术球后阻滞中加入0.25微克/千克右美托咪定，将显著延长球后阻滞的持续时间，并提高外科医生和患者的满意度。
