Duguid I G, Claoué C M, Thamby-Rajah Y, Allan B D, Dart J K, Steele A D
Moorfields Eye Hospital, London, UK.
Eye (Lond). 1995;9 ( Pt 4):456-9. doi: 10.1038/eye.1995.106.
Although phacoemulsification with only topical anaesthesia is possible, the level of any discomfort perceived by the patient is unknown. Topical anaesthesia eliminates any risk of inadvertent ocular or orbital injury. Twenty-four patients undergoing phacoemulsification under only topical anaesthesia (g. amethocaine 1%) were compared with 23 patients undergoing the same procedure with peribulbar anaesthesia (5 ml lignocaine 2%, 5 ml bupivacaine 0.5% and 75 units hyaluronidase). Perceived pain on administration of the anaesthesia, per-operatively and post-operatively was assessed by a nursing officer using a visual analogue scale (0-10). It was found that there was no difference in pain score between the two groups on induction of anaesthesia. Per-operatively and post-operatively scores were higher in the topical group than in the peribulbar group (p < 0.05, Mann-Whitney U-test), though most of these were within the range 0-3, ('no pain' to 'slight pain'). There was no difference in the amount of analgesia dispensed to the two groups on the ward post-operatively. In conclusion, topical anaesthesia provides adequate anaesthesia for phacoemulsification. Although a small increase in the level of discomfort was observed, the pain levels reported were small and may not be clinically significant when set against the reduced incidence of anaesthetic-related complications.
尽管仅使用表面麻醉进行超声乳化手术是可行的，但患者所感受到的任何不适程度尚不清楚。表面麻醉消除了意外眼内或眼眶损伤的任何风险。将24例仅接受表面麻醉（1%丁卡因）进行超声乳化手术的患者与23例接受球周麻醉（2%利多卡因5ml、0.5%布比卡因5ml和透明质酸酶75单位）进行相同手术的患者进行比较。一名护理人员使用视觉模拟量表（0 - 10）评估麻醉给药时、手术中和手术后所感受到的疼痛。结果发现，两组在麻醉诱导时的疼痛评分没有差异。表面麻醉组在手术中和手术后的评分高于球周麻醉组（p < 0.05，曼-惠特尼U检验），尽管其中大多数在0 - 3分范围内（“无疼痛”至“轻微疼痛”）。两组术后在病房使用的镇痛药量没有差异。总之，表面麻醉为超声乳化手术提供了足够的麻醉。尽管观察到不适程度略有增加，但所报告的疼痛程度较小，与麻醉相关并发症发生率降低相比，可能在临床上不具有显著意义。
