Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, 800 Washington Street, Box 298, Boston, MA, USA.
Tufts University School of Medicine, Boston, MA, USA.
Can J Anaesth. 2020 May;67(5):560-567. doi: 10.1007/s12630-020-01588-6. Epub 2020 Feb 13.
Application of adhesive tape to the eyelids during general anesthesia decreases the risk of corneal abrasion but may increase the risk of eyelid injury. The aim of this study was to determine if there is a difference in eyelid erythema when covering the eyelid with either Tegaderm™ or an EyeGard®.
We conducted a prospective, randomized, double-blind, split-face study of patients undergoing general anesthesia at an urban tertiary care academic medical centre. Each patient was randomized to having one eyelid covered with Tegaderm and the other with EyeGard. Photographs were taken prior to extubation and evaluated by three dermatologists. The primary outcome was the incidence of postoperative eyelid erythema. Secondary outcomes included the incidence of corneal abrasion and patient satisfaction.
A total of 151 patients were included in our final analysis. Erythema was present on 117 (77%) eyelids covered with Tegaderm and 105 (70%) eyelids covered with EyeGard (% difference, 8; 95% confidence interval, 2 to 14; P = 0.03). No corneal abrasions were reported. The median [interquartile range] patient satisfaction score with eyelid condition was similar with Tegaderm vs EyeGard (5 [5-5] vs 5 [5-5], respectively; P = 0.84).
We found a small increase in postoperative eyelid erythema when using Tegaderm compared with EyeGard. While EyeGard could decrease the risk of eyelid erythema, this should be balanced against other potential benefits of Tegaderm such as protection from fluids leaking onto the cornea.
www.ClinicalTrials.gov (NCT03549429); registered 8 June, 2018.
在全身麻醉期间将胶带贴在眼睑上可降低角膜擦伤的风险,但可能增加眼睑损伤的风险。本研究旨在确定使用 Tegaderm™ 或 EyeGard® 覆盖眼睑时,眼睑红斑是否存在差异。
我们对在城市三级保健学术医疗中心接受全身麻醉的患者进行了一项前瞻性、随机、双盲、分面研究。每位患者均随机分为一侧眼睑用 Tegaderm 覆盖,另一侧用 EyeGard 覆盖。在拔出气管导管前拍摄照片,并由三位皮肤科医生进行评估。主要结局是术后眼睑红斑的发生率。次要结局包括角膜擦伤的发生率和患者满意度。
共有 151 例患者纳入最终分析。在使用 Tegaderm 覆盖的 117 (77%)只眼睑和使用 EyeGard 覆盖的 105 (70%)只眼睑上存在红斑(差异百分比为 8%;95%置信区间为 2 至 14%;P = 0.03)。没有报告角膜擦伤。使用 Tegaderm 和 EyeGard 时,患者对眼睑状况的满意度评分中位数[四分位距]相似(5 [5-5] 与 5 [5-5],分别;P = 0.84)。
与 EyeGard 相比,我们发现使用 Tegaderm 时术后眼睑红斑略有增加。虽然 EyeGard 可以降低眼睑红斑的风险,但这应与 Tegaderm 防止液体漏到角膜上的其他潜在益处相平衡。
www.ClinicalTrials.gov(NCT03549429);注册于 2018 年 6 月 8 日。