Merli G J, Weitz H, Martin J H, McClay E F, Adler A G, Fellin F M, Libonati M
Arch Intern Med. 1986 Jan;146(1):45-7.
Atropine sulfate, a mydriatic and cycloplegic agent, is frequently used in patients undergoing glaucoma surgery. Trabeculectomy with peripheral iridectomy is the most common glaucoma surgery performed to decrease intraocular pressure and preserve vision. Systemic absorption of ophthalmic atropine does occur and may result in toxic and adverse side effects. Cardiac dysrhythmias are one of the major adverse reactions. This case study reviews three patients who had a trabeculectomy for glaucoma and received ophthalmic atropine. One patient received both systemic and ocular atropine. Two patients developed atrial fibrillation and one a supraventricular tachycardia. Two patients required admission to a cardiac intensive care unit for management of the dysrhythmia and a third reverted to normal sinus rhythm spontaneously. The cardiac effects of ophthalmic atropine should be considered in the preoperative and postoperative assessment of patients with dysrhythmias.
硫酸阿托品是一种散瞳及睫状肌麻痹剂，常用于接受青光眼手术的患者。小梁切除术联合周边虹膜切除术是最常见的用于降低眼压和保护视力的青光眼手术。眼科用阿托品确实会发生全身吸收，并可能导致毒性和不良副作用。心律失常是主要的不良反应之一。本病例研究回顾了三名接受青光眼小梁切除术并使用眼科用阿托品的患者。一名患者同时接受了全身和眼部阿托品治疗。两名患者发生房颤，一名发生室上性心动过速。两名患者因心律失常需要入住心脏重症监护病房，第三名患者自行恢复为正常窦性心律。在对有心律失常的患者进行术前和术后评估时，应考虑眼科用阿托品对心脏的影响。
