Schimek F, Steuhl K P, Fahle M
Department of Anesthesiology, University of Tübingen, Germany.
Ophthalmic Surg. 1993 Mar;24(3):171-80.
Somatosensory, motor, and visual sensory blockade were investigated after retrobulbar injection of 3 mL 2% lidocaine, prilocaine, or mepivacaine plus hyaluronidase (15 U/mL) and naphazoline nitrate (1:20,000) in 90 cataract patients (n = 30 per group). Before injection as well as 20 and 90 minutes after injection, and then every 30 minutes, the quality of the retrobulbar blockade was evaluated in terms of the following factors until full recovery of function: (1) corneal sensitivity at the three extraincisional quadrants as determined with an esthesiometer; (2) horizontal and vertical motility, and elevation of the lid; (3) visual acuity on an arbitrary score scale ranging from 0 (no light perception) to 6 (visual acuity > 0.05); and (4) the time required for recovery from retrobulbar anesthesia. The data were analyzed by one- (anesthetic) and two-factor (anesthetic and time) analysis of variance. Full somatic recovery of corneal sensitivity occurred within 247 +/- 10.2 minutes after lidocaine, within 221 +/- 9.2 minutes after prilocaine, and within 280 +/- 8.5 minutes after mepivacaine (F = 10.1; P < .0001). Full motor recovery (all muscles) occurred within 290 +/- 5.8 minutes after lidocaine, within 258 +/- 5.7 minutes after prilocaine, and within 295 +/- 4.8 minutes after mepivacaine (F = 13.3, P < .0001). On the average, visual acuity decreased most after mepivacaine and least after lidocaine administration, although the differences between the three anesthetics in this regard were not significant. One patient temporarily lost vision after mepivacaine administration. Overall, the somatosensory and motor blockade were most pronounced after mepivacaine.
在90例白内障患者（每组n = 30）球后注射3 mL 2%利多卡因、丙胺卡因或甲哌卡因加透明质酸酶（15 U/mL）和硝酸萘甲唑啉（1:20,000）后，对感觉、运动和视觉感觉阻滞进行了研究。在注射前以及注射后20分钟和90分钟，然后每30分钟，根据以下因素评估球后阻滞的质量，直至功能完全恢复：（1）用感觉计测定三个切口外象限的角膜敏感性；（2）水平和垂直运动以及眼睑抬高；（3）视力采用从0（无光感）到6（视力>0.05）的任意评分量表；（4）从球后麻醉恢复所需的时间。数据采用单因素（麻醉剂）和双因素（麻醉剂和时间）方差分析。利多卡因注射后角膜感觉完全恢复发生在247±10.2分钟内，丙胺卡因注射后在221±9.2分钟内，甲哌卡因注射后在280±8.5分钟内（F = 10.1；P <.0001）。利多卡因注射后290±5.8分钟内所有肌肉运动完全恢复，丙胺卡因注射后在258±5.7分钟内，甲哌卡因注射后在295±4.8分钟内（F = 13.3，P <.0001）。平均而言，甲哌卡因给药后视力下降最多，利多卡因给药后最少，尽管三种麻醉剂在这方面的差异不显著。一名患者在甲哌卡因给药后暂时失明。总体而言，甲哌卡因后的感觉和运动阻滞最为明显。
