右美托咪定作为青光眼手术球周阻滞辅助用药对眼内压的影响。

Effect of dexmedetomidine on intraocular pressure as an additive in peribulbar block during glaucoma surgery.

机构信息

Glaucoma Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India.

Department of Anesthesiology, Dr. Shroff's Charity Eye Hospital, New Delhi, India.

出版信息

Indian J Ophthalmol. 2021 Mar;69(3):612-616. doi: 10.4103/ijo.IJO_1152_20.

DOI:10.4103/ijo.IJO_1152_20

PMID:33595486

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7942109/

Abstract

PURPOSE

The purpose of this study is to assess the effect of dexmedetomidine on intraocular pressure (IOP) as an additive in peribulbar injections in glaucoma surgeries.

METHODS

A prospective, randomized, double-blind, parallel assignment interventional study was conducted for patients undergoing glaucoma surgeries at a tertiary eye care hospital in North India. Patients were randomized to two groups, Dexmed group and Placebo group. In the Dexmed group, dexmedetomidine (0.4 μg/kg body weight) was given as an additive along with peribulbar block. The primary outcome was change in IOP pre- and postperibulbar injections (IOP before the block, and after 5 and 15 min of the block). Secondary outcome measures were onset of block, adverse effects (bradycardia, hypotension, respiratory depression, and level 4 sedation), and surgeon satisfaction.

RESULTS

A total of 104 patients were randomized, 52 each in the Dexmed group and Placebo group. The percentage decrease in IOP was significantly more in the Dexmed group than in the Placebo group both at 5 and 15 min' post block (P < 0.05). At 5 min, the mean percent decrease in IOP in Dexmed group was -10.48, whereas it was 2.85 in the Placebo group. At 15 min, the mean percent decrease in IOP was -22.59 and -9.42 in the Dexmed and Placebo group, respectively. There was no significant difference between the two groups in the onset of block and adverse effects. Surgeon satisfaction was significantly greater in the Dexmed group than the Placebo group (P < 0.05).

CONCLUSION

Dexmedetomidine lowers IOP significantly in patients undergoing glaucoma surgeries with safe hemodynamic changes and sedative effect.

摘要

目的

本研究旨在评估右美托咪定作为青光眼手术中球周注射的附加药物对眼内压（IOP）的影响。

方法

在印度北部的一家三级眼科医院对接受青光眼手术的患者进行了一项前瞻性、随机、双盲、平行分组的干预性研究。患者随机分为两组，右美托咪定组和安慰剂组。在右美托咪定组中，右美托咪定（0.4μg/kg 体重）作为附加药物与球周阻滞一起使用。主要结局是球周注射前后的 IOP 变化（阻滞前的 IOP 以及阻滞后 5 分钟和 15 分钟的 IOP）。次要结局指标包括阻滞起效时间、不良反应（心动过缓、低血压、呼吸抑制和 4 级镇静）和外科医生满意度。

结果

共随机分配了 104 例患者，每组 52 例，分别纳入右美托咪定组和安慰剂组。在 5 分钟和 15 分钟时，右美托咪定组的 IOP 下降百分比明显高于安慰剂组（P<0.05）。在 5 分钟时，右美托咪定组的平均 IOP 下降百分比为-10.48%，而安慰剂组为 2.85%。在 15 分钟时，右美托咪定组和安慰剂组的平均 IOP 下降百分比分别为-22.59%和-9.42%。两组之间的阻滞起效时间和不良反应无显著差异。右美托咪定组的外科医生满意度明显高于安慰剂组（P<0.05）。