Kumar Chandra M, Chua Alfred W Y, Imani Farnad, Sehat-Kashani Saloome
Department of Anaesthesia, Khoo Teck Puat Hospital, Yishun, Singapore.
Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney, Australia.
Anesth Pain Med. 2021 Sep 18;11(4):e118271. doi: 10.5812/aapm.118271. eCollection 2021 Aug.
Cataract surgery is predominantly performed under local/regional anesthesia, with or without sedation. The practice pattern of sedation is unknown and seems to vary significantly among institutions and countries, routinely administered in some parts of the world to the other extreme of none at all. The selection of sedative agents and techniques varies widely. Currently, there is no ideal sedative agent. Dexmedetomidine has gained recent attention for sedation in ophthalmic local/regional anesthesia due to its alleged advantages of effective sedation with minimal respiratory depression, decreased intraocular pressure, and reduced pain during the local anesthetic injection; however, they are subject to differing interpretations. Published literature also suggests that although dexmedetomidine sedation for cataract surgery under local/regional anesthesia is potentially useful, its role may be limited due to logistical difficulties in administering the recommended dose.
白内障手术主要在局部/区域麻醉下进行，可使用或不使用镇静剂。镇静的实践模式尚不清楚，而且在不同机构和国家之间似乎差异很大，在世界某些地区常规使用，而在另一些地区则根本不使用。镇静剂的选择和技术差异很大。目前，尚无理想的镇静剂。右美托咪定因其在眼科局部/区域麻醉中具有有效镇静、呼吸抑制最小、眼压降低以及局部麻醉注射时疼痛减轻等所谓优势，近来受到关注；然而，这些优势存在不同的解读。已发表的文献还表明，尽管右美托咪定用于局部/区域麻醉下的白内障手术镇静可能有用，但其作用可能因推荐剂量给药的后勤困难而受到限制。
