Scuderi Gianluca, Scuderi Luca, Calafiore Silvia, Fenicia Vito, Abdolrahimzadeh Solmaz
Ophthalmology Unit, NESMOS Department, St. Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, Rome, Italy.
Ophthalmology Unit, Department of Sense Organs, Azienda Policlinico Umberto I, "Sapienza "University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
Int Ophthalmol. 2019 Dec;39(12):2851-2856. doi: 10.1007/s10792-019-01132-6. Epub 2019 May 31.
To assess safety and efficacy of deep topical anesthesia with ropivacaine-soaked sponge compared with topical anesthesia with oxybuprocaine in patients undergoing phacoemulsification.
This was a retrospective study where records of patients operated for cataract were evaluated. Patients using a visual analogue scale scored pain during surgery, and the surgeon on a questionnaire recorded ease of operation. Medical records were evaluated for patients who received topical anesthesia with multiple administrations of oxybuprocaine 0.4% or those who received deep topical anesthesia with a polyvinyl acetal sponge impregnated with ropivacaine 0.75% and positioned under the eyelid 30 min before surgery.
A total of one hundred patient records, equally divided in patients receiving deep topical anesthesia or topical anesthesia, were included. The visual analogue scale scores among the groups were statistically significant for a lower pain score in patients who received deep topical anesthesia with ropivacaine-soaked sponges (p = 0.0069). The average surgeon score was significantly higher for the deep topical anesthesia group indicating favorable ease of surgery (p = 0.0341). Six patients had major complications during surgery. No additional anesthesia was necessary to manage the complications in four patients in the deep anesthesia group, whereas propofol was used for the induction and maintenance of anesthesia in two patients in the topical anesthesia group.
Deep topical anesthesia with ropivacaine-soaked sponges performed as well as topical oxybuprocaine regarding safety and efficacy. It provided a lower patient pain score, favorable surgeon satisfaction, and long-lasting anesthesia.
评估与丙氧卡因表面麻醉相比，罗哌卡因浸润海绵深层表面麻醉在白内障超声乳化手术患者中的安全性和有效性。
这是一项回顾性研究，对白内障手术患者的记录进行评估。患者使用视觉模拟量表对手术期间的疼痛进行评分，外科医生通过问卷记录手术的难易程度。对接受多次使用0.4%丙氧卡因表面麻醉的患者或接受术前30分钟将浸有0.75%罗哌卡因的聚乙烯醇缩醛海绵置于眼睑下进行深层表面麻醉的患者的病历进行评估。
共纳入100例患者记录，接受深层表面麻醉或表面麻醉的患者各占一半。接受罗哌卡因浸润海绵深层表面麻醉的患者疼痛评分较低，两组间视觉模拟量表评分具有统计学意义（p = 0.0069）。深层表面麻醉组的外科医生平均评分显著更高，表明手术操作更轻松（p = 0.0341）。6例患者在手术期间出现严重并发症。深层麻醉组有4例患者处理并发症时无需额外麻醉，而表面麻醉组有2例患者使用丙泊酚诱导和维持麻醉。
罗哌卡因浸润海绵深层表面麻醉在安全性和有效性方面与丙氧卡因表面麻醉相当。它能降低患者疼痛评分，提高外科医生满意度，并提供持久的麻醉效果。
