Bartfield J M, Holmes T J, Raccio-Robak N
Department of Emergency Medicine Albany Medical College, NY 12208, USA.
Acad Emerg Med. 1994 Jul-Aug;1(4):364-7. doi: 10.1111/j.1553-2712.1994.tb02646.x.
To compare two topical eye anesthetics, proparacaine and tetracaine, for pain of instillation and duration of activity.
Volunteers received both anesthetics in a prospective, randomized, double-masked protocol. The subjects were given one drop of a study solution in the lower lid fornix of the left eye. Immediately after receiving the medication, they rated the pain of instillation on a previously validated visual-analog pain scale. This procedure was then repeated in the right eye with the other study solution. Pain scales were quantified by making measurements to the nearest millimeter from the point of scale origin to the point marked by the patient. The time interval until return of the corneal blink reflex was determined using a cotton wisp. Pain scores and the time to return of corneal reflex were analyzed by the Sign test and Wilcoxon rank-sum test, respectively, with significance defined as p < 0.05.
Twenty-three subjects were available for analysis. Twenty subjects reported proparacaine hurt less than tetracaine, two felt the pain was the same for the two agents, and only one reported that proparacaine was more painful. The mean pain score for tetracaine was 24 mm (100 mm maximum) higher than that for proparacaine (p < 0.0002). Proparacaine lasted 1.3 minutes longer than tetracaine, 10.7 minutes versus 9.4 minutes (p = 0.0001).
Proparacaine eye drops cause less pain than tetracaine eye drops upon instillation. Anesthesia from proparacaine last slightly longer. These properties make proparacaine preferable to tetracaine.
比较两种局部眼部麻醉剂丙美卡因和丁卡因在滴眼时的疼痛程度及作用持续时间。
志愿者按照前瞻性、随机、双盲方案接受两种麻醉剂。受试者在左眼的下睑穹窿滴入一滴研究溶液。用药后立即，他们根据先前验证的视觉模拟疼痛量表对滴眼时的疼痛进行评分。然后用另一种研究溶液对右眼重复此过程。通过测量从量表起点到患者标记点的最接近毫米数来量化疼痛量表。使用棉棒确定角膜眨眼反射恢复的时间间隔。分别通过符号检验和威尔科克森秩和检验分析疼痛评分和角膜反射恢复时间，显著性定义为p < 0.05。
23名受试者可供分析。20名受试者报告丙美卡因比丁卡因疼痛轻，2名感觉两种药物疼痛相同，只有1名报告丙美卡因更痛。丁卡因的平均疼痛评分为24毫米（最大100毫米），高于丙美卡因（p < 0.0002）。丙美卡因的持续时间比丁卡因长1.3分钟，分别为10.7分钟和9.4分钟（p = 0.0001）。
丙美卡因滴眼液滴眼时引起的疼痛比丁卡因滴眼液少。丙美卡因的麻醉持续时间略长。这些特性使丙美卡因比丁卡因更具优势。
