Ripart J, Lefrant J Y, Lalourcey L, Benbabaali M, Charavel P, Mainemer M, Prat-Pradal D, Dupeyron G, Eledjam J J
Department d'Anesthésie-Réanimation, Centre Hospitalier et Universitaire de Nimes, France.
Anesth Analg. 1996 Dec;83(6):1234-8. doi: 10.1097/00000539-199612000-00018.
We studied 151 consecutive patients scheduled for elective short-duration ophthalmic procedures to assess the efficacy of an alternative approach to periocular anesthesia. Single injection at the medial canthus was performed with a 25-gauge needle. The studied variables were: injected volume, onset time of the block, akinesia (scored on a 12-point scale), adequate surgical anesthesia (scored on a 5-point scale), and need for reinjection. The injected volume of local anesthetic solution was 8.6 +/- 1.7 mL. The onset time of anesthesia was 6.9 +/- 3.0 min, with an akinesia score of 11.6 +/- 1.1 (maximum 12). Additional reinjections were necessary in 14 cases (9.2%). There was a learning curve for the technique, with 8 of the additional injections being performed in the first 30 patients (26.6%), and 6 in the last 121 (4.9%). The surgical score recorded after surgery was 4.8 +/- 0.6 (maximum 5). There were no complications, including injury to the globe, optic nerve, or retina or orbital hematoma. Medial canthus single injection periocular anesthesia appears to be a promising alternative to the usual double injection peribulbar block.
我们研究了151例计划接受择期短期眼科手术的连续患者，以评估一种替代眼周麻醉方法的疗效。使用25号针头在内眦进行单次注射。研究的变量包括：注射量、阻滞起效时间、运动不能（采用12分制评分）、充分的手术麻醉（采用5分制评分）以及再次注射的必要性。局部麻醉溶液的注射量为8.6±1.7 mL。麻醉起效时间为6.9±3.0分钟，运动不能评分为11.6±1.1（满分12分）。14例患者（9.2%）需要再次注射。该技术存在学习曲线，在前30例患者中有8例进行了额外注射（26.6%），在最后121例中有6例（4.9%）。术后记录的手术评分为4.8±0.6（满分5分）。未发生并发症，包括眼球、视神经、视网膜损伤或眼眶血肿。内眦单次注射眼周麻醉似乎是常用的球周阻滞双次注射的一种有前景的替代方法。
