碳酸氢钠与透明质酸酶对白内障手术球周麻醉期间疼痛感知、麻醉及运动不能影响的比较研究

A Comparative Study of Sodium Bicarbonate and Hyaluronidase on Pain Perception, Anesthesia, and Akinesia during Peribulbar Anesthesia for Cataract Surgery.

作者信息

Sodani Priyanka, Dogra Sandeepika, Raj Dev, Bhagat Vabita

机构信息

Department of Ophthalmology, Government Medical College, Kathua, Jammu and Kashmir, India.

Department of Anesthesia and Critical Care, Government Medical College, Kathua, Jammu and Kashmir, India.

出版信息

Anesth Essays Res. 2022 Jan-Mar;16(1):31-35. doi: 10.4103/aer.aer_128_21. Epub 2022 May 31.

DOI:10.4103/aer.aer_128_21

PMID:36249141

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9558670/

Abstract

BACKGROUND

An ideal anesthetic solution should provide good anesthesia and akinesia with minimal pain on injection.

AIMS

The aim of this study is to determine the effect on pain perception and efficacy of sodium bicarbonate over hyaluronidase in the local anesthetic mixture during peribulbar anesthesia.

SETTINGS AND DESIGN

A prospective, randomized, double-blind study.

MATERIALS AND METHODS

An independent observer labeled two injections as A (hyaluronidase 1500 IU in 30 mL of lignocaine) and B (7.5% sodium bicarbonate 1 mL in 30 mL of lignocaine). Group 1 was injected with injection A while Group 2 was injected with injection B. The visual analog scale (VAS) was used to determine the intensity of pain. Onset and degree of anesthesia and akinesia were recorded.

STATISTICAL ANALYSIS

Computer software Microsoft Excel SPSS version 26 (Chicago Inc) for windows was used. The qualitative data and quantitative data were reported as proportions and mean ± (standard deviation), respectively. Chi-square test for proportions was used for the comparison of qualitative variables and unpaired Student's -test was used to test the significance between quantitative variables. < 0.05 was considered statistically significant. All were two-tailed.

RESULTS

Out of 123 patients, 23 were excluded from the study. Hundred patients were divided into Group 1 and Group 2. The mean age in Group 1 was 64.92 ± 10.77 years while in Group 2 was 62.86 ± 11.17 years. The mean heart rate and mean systolic blood pressure in both groups were statistically insignificant. Group 2 experienced very less pain (mean pain score VAS = 5.12 ± 1.17) as compared to Group 1 (mean pain score was 7.16 ± 1.09) and the difference between both the groups was found to be statistically significant. There was a significant difference in the onset of anesthesia in both groups ( = 0.001). In the sodium bicarbonate group, the onset was faster. The onset of akinesia was better in Group 1 (4.76 ± 2.06 min). Grading of akinesia was better in Group 1.

CONCLUSION

Sodium bicarbonate reduces pain on injection in peribulbar anesthesia and also results in a quicker onset of anesthesia.

摘要

背景

理想的麻醉溶液应能提供良好的麻醉和运动不能效果，且注射时疼痛最小。

目的

本研究旨在确定在球周麻醉的局部麻醉混合液中，碳酸氢钠与透明质酸酶相比对疼痛感知和疗效的影响。

设置与设计

一项前瞻性、随机、双盲研究。

材料与方法

一名独立观察者将两种注射液分别标记为A（30 mL利多卡因中含1500 IU透明质酸酶）和B（30 mL利多卡因中含1 mL 7.5%碳酸氢钠）。第1组注射A液，第2组注射B液。采用视觉模拟评分法（VAS）确定疼痛强度。记录麻醉和运动不能的起效时间及程度。

统计分析

使用适用于Windows的计算机软件Microsoft Excel SPSS 26版（芝加哥公司）。定性数据和定量数据分别以比例和均值±（标准差）表示。采用卡方检验比较定性变量，采用非配对学生t检验检验定量变量之间的显著性。P<0.05被认为具有统计学显著性。所有检验均为双侧检验。

结果

123例患者中，23例被排除在研究之外。100例患者被分为第1组和第2组。第1组的平均年龄为64.92±10.77岁，第2组为62.86±11.17岁。两组的平均心率和平均收缩压在统计学上无显著差异。与第1组（平均疼痛评分VAS = 7.16±1.09）相比，第2组经历的疼痛非常少（平均疼痛评分VAS = 5.12±1.17），两组之间的差异具有统计学显著性。两组麻醉起效时间存在显著差异（P = 0.001）。在碳酸氢钠组，起效更快。第1组运动不能的起效更好（4.76±2.06分钟）。第1组运动不能的分级更好。