Rahimi Varposhti Mojtaba, Moradi Farsani Darioush, Ghadimi Keyvan, Asadi Mehrdad
a Department of Anesthesiology, Faculty of Medicine , Isfahan University of Medical Sciences , Isfahan.
b School of medicine , Isfahan University of Medical Sciences , Isfahan.
Strabismus. 2019 Mar;27(1):1-5. doi: 10.1080/09273972.2018.1561732. Epub 2019 Mar 4.
Recently, to reduce the incidence of oculocardiac reflex (OCR) in strabismus surgery, retrobulbar block and anticholinergic drugs or local anesthesia are also used. The present study evaluated the effects of Tetracaine eye drop as a topical nerve blocker on OCR during strabismus surgery.
In this randomized trial, 70 strabismus surgery candidates were randomly divided into placebo or synthetic teardrop (E) and Tetracaine eye drop (T) groups, so 3 drops of each solution were dropped in four directions of patients' eye immediately after applying anesthesia and before surgery. The incidence and severity of OCR during the stages of muscle release and incision (cutting), hemodynamic changes, the required time for OCR recovery and atropine dose were assessed.
OCR was more seen in release phase compared to cutting phase. There were no significant differences between two group regarding the incidence and severity of OCR in the release phase (p > 0.05), but the incidence and severity of OCR in the cutting phase was more in group E than group T (p = 0.02, for both). The duration of OCR improvement (p-value = 0.74) and Atropine consumption (p-value = 0.92) did not differ between the groups.
Tetracaine eye drop only reduces the incidence and severity of OCR during the incision stage of strabismus surgery.
最近,为了降低斜视手术中眼心反射(OCR)的发生率,也采用球后阻滞、抗胆碱能药物或局部麻醉。本研究评估了丁卡因滴眼液作为局部神经阻滞剂在斜视手术中对眼心反射的影响。
在这项随机试验中,70名斜视手术候选者被随机分为安慰剂或人工泪液(E)组以及丁卡因滴眼液(T)组,因此在麻醉后和手术前,将每种溶液的3滴分别滴入患者眼睛的四个方向。评估了肌肉松解和切开(切割)阶段眼心反射的发生率和严重程度、血流动力学变化、眼心反射恢复所需时间以及阿托品剂量。
与切开阶段相比,眼心反射在松解阶段更常见。两组在松解阶段眼心反射的发生率和严重程度方面无显著差异(p>0.05),但在切开阶段,E组的眼心反射发生率和严重程度高于T组(两者p值均为0.02)。两组之间眼心反射改善持续时间(p值=0.74)和阿托品消耗量(p值=0.92)无差异。
丁卡因滴眼液仅能降低斜视手术切开阶段眼心反射的发生率和严重程度。