Hampl K F, Marsch S C, Erb T, Drewe J, Schneider M C
Department of Anaesthesia, University of Basel, Kantonsspital, Switzerland.
Acta Anaesthesiol Scand. 1996 Jan;40(1):53-8. doi: 10.1111/j.1399-6576.1996.tb04388.x.
Principle goals of sedation for eye surgery are to provide patient comfort and to allow the patient to stay calm during both retrobulbar injection and surgery. Insufficient sedation may not prevent the patient from moving during retrobulbar injection, whereas very deep sedation may result in respiratory complications during surgery. The aim of the present study was to evaluate the effectiveness and suitability of a combination of diazepam and propofol for sedation for both application of retrobulbar block and subsequent elective eye surgery. One-hundred and fifty patients were randomly allocated to receive either diazepam, propofol or a combination of both drugs before retrobulbar injection. Tolerance of retrobulbar injection and comfort during the surgical procedure were assessed by comfort scores using a nominal analogue scale between 1 (worst possible condition) and 6 (best conceivable condition). Side effects related to sedation were recorded. The combination of diazepam and propofol resulted in the highest comfort scores for both retrobulbar block (5.3 +/- 0.3) and the surgical procedure (5.4 +/- 0.4). Diazepam alone did not produce adequate sedation for retrobulbar block (3.1 +/- 0.3), whereas comfort scores during surgery were significantly higher (5.3 +/- 0.3) compared to propofol alone (3.6 +/- 0.4). No severe side effects induced by sedation were noted in any of the study groups. The combination of diazepam and propofol proved able to provide a reliable degree of sedation with minimal side effects for both retrobulbar block and surgery. The combination was clearly superior to the sedation induced by propofol or diazepam alone.
眼科手术镇静的主要目标是让患者感到舒适，并使其在球后注射和手术过程中保持平静。镇静不足可能无法防止患者在球后注射时移动，而深度镇静可能会在手术期间导致呼吸并发症。本研究的目的是评估地西泮和丙泊酚联合用于球后阻滞及后续择期眼科手术镇静的有效性和适用性。150例患者在球后注射前被随机分配接受地西泮、丙泊酚或两种药物联合使用。通过使用1（最差情况）至6（最佳情况）的标称模拟量表的舒适度评分来评估球后注射的耐受性和手术过程中的舒适度。记录与镇静相关的副作用。地西泮和丙泊酚联合使用在球后阻滞（5.3±0.3）和手术过程（5.4±0.4）中均产生了最高的舒适度评分。单独使用地西泮对球后阻滞没有产生足够的镇静效果（3.1±0.3），而与单独使用丙泊酚（3.6±0.4）相比，手术期间的舒适度评分显著更高（5.3±0.3）。在任何研究组中均未观察到由镇静引起的严重副作用。地西泮和丙泊酚联合使用被证明能够为球后阻滞和手术提供可靠程度的镇静，且副作用最小。该联合用药明显优于单独使用丙泊酚或地西泮引起的镇静效果。
