Department of Ophthalmology, Military Hospital, Gwalior, Madhya Pradesh, India.
Department of Anaesthesia, Military Hospital, Gwalior, Madhya Pradesh, India.
Indian J Ophthalmol. 2021 Apr;69(4):923-926. doi: 10.4103/ijo.IJO_1019_20.
This study compares the vital parameters and pain experienced during phacoemulsification under peribulbar and topical anesthesia to determine the incidence of OCR.
One hundred six patients are enrolled for phacoemulsification in a prospective and randomized study. Fifty-two patients undergo surgery in a peribulbar block (Group PB) and 54 in topical anesthesia (Group TA). Mean arterial pressure (MAP) and pulse rate are recorded during a preoperative check-up and at four other steps of surgery. Pain experienced during surgery and on a postoperative day, 5, is graded with a verbal analogue scale. OCR defined as a decrease in pulse rate by greater than 20% is calculated. Chi-square test, Fisher's exact test, paired t test and the comparison of means give the statistical analysis. A value of P < 0.05 was taken as significant.
MAP readings at baseline versus MAP at other steps of surgery show a trend towards rising with a P value of < 0.05 in both groups. Pulse rate measured at all steps of surgery versus baseline pulse rate in Group TA shows P < 0.05. OCR is present in nine patients in peribulbar block verses eleven patients in topical anesthesia with P value of 0.687. The pain scores using verbal analogue scale were higher in Group TA compared with Group PB with a P < 0.0001.
Oculocardiac reflex can occur during phacoemulsification under both peribulbar block and topical anesthesia, and the difference is not significant.
本研究比较球周麻醉和表面麻醉下超声乳化白内障吸除术的生命体征和疼痛，以确定眼心反射（OCR）的发生率。
106 例患者前瞻性随机分为球周麻醉组（PB 组，52 例）和表面麻醉组（TA 组，54 例）行超声乳化白内障吸除术。术前检查和手术的其他 4 个步骤记录平均动脉压（MAP）和脉搏率。手术期间和术后第 5 天的疼痛用语言模拟量表进行分级。计算脉搏率下降超过 20%的 OCR。采用卡方检验、Fisher 确切检验、配对 t 检验和均数比较进行统计学分析。P 值<0.05 为有统计学意义。
PB 组和 TA 组的基础 MAP 与其他手术步骤的 MAP 相比，呈升高趋势，P 值均<0.05。TA 组在所有手术步骤中测量的脉搏率与基础脉搏率相比，P 值<0.05。PB 组中有 9 例患者发生 OCR，TA 组中有 11 例患者发生 OCR，P 值为 0.687。TA 组的语言模拟量表疼痛评分高于 PB 组，P 值<0.0001。
球周麻醉和表面麻醉下超声乳化白内障吸除术均可发生眼心反射，差异无统计学意义。
