Ruta U, Gerding H, Möllhoff T
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Universität Münster.
Ophthalmologe. 1997 May;94(5):354-9. doi: 10.1007/s003470050128.
The oculocardiac reflex causes severe bradycardic arrhythmias and is a frequent complication during surgical manipulation at the medial rectus muscle. The purpose of this study was to evaluate the influence of lidocaine administered topically on the muscle on the incidence of the oculocardiac reflex.
After obtaining informed consent, 140 patients with strabism or retinal surgery were included in this study. All patients received standard premedication and anesthesia and were randomly assigned to two groups. Patients (n = 70) randomly assigned to the first group received 1 mg/kg lidocaine applied topically to the muscle after opening the conjunctiva. Individuals in the placebo group received the same volume of saline (0.9%). Surgical stimulation occurred 5 min after administration of the drug. The study parameters (blood pressure/heart rate) were recorded before and after stimulation of the oculocardiac reflex caused by routine surgical preparation.
Topical administration of lidocaine reduced the incidence of the oculocardiac reflex (86.1% vs 37.1%), and the frequency of severe bradycardiac arrhythmias was also significantly reduced (40 vs. 2.9%). Cardiac arrest for longer than 10 s did not occur in the lidocaine group. In the control group this phenomenon was observed in 14.8%.
眼心反射可导致严重的缓慢性心律失常，是内直肌手术操作过程中常见的并发症。本研究的目的是评估局部应用利多卡因于肌肉对眼心反射发生率的影响。
获得知情同意后，140例斜视或视网膜手术患者纳入本研究。所有患者均接受标准的术前用药和麻醉，并随机分为两组。随机分配至第一组的患者（n = 70）在打开结膜后将1 mg/kg利多卡因局部应用于肌肉。安慰剂组患者接受相同体积的生理盐水（0.9%）。给药5分钟后进行手术刺激。在常规手术准备引起眼心反射刺激前后记录研究参数（血压/心率）。
局部应用利多卡因降低了眼心反射的发生率（86.1%对37.1%），严重缓慢性心律失常的频率也显著降低（40对2.9）。利多卡因组未发生超过10秒的心脏骤停。在对照组中，这一现象的发生率为14.8%。
