Azuara-Blanco A, Moster M R, Marr B P
Glaucoma Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, PA 19107, USA.
Ophthalmic Surg Lasers. 1997 Nov;28(11):896-9.
To compare the use of subconjunctival and peribulbar anesthesia for trabeculectomy.
Sixty patients undergoing trabeculectomy were prospectively randomized to receive either peribulbar or subconjunctival anesthesia. Peribulbar anesthesia consisted of a 3-ml inferior and a 1-ml superior injection of a 1:1 mixture of 2% mepivacaine, 0.75% bupivacaine, and hyaluronidase. Subconjunctival anesthesia consisted of a 1- to 2-ml injection of the same mixture without hyaluronidase in the superotemporal quadrant. Intraoperative pain, presence of eye movements, and complications during surgery were evaluated.
The frequency and intensity of pain was statistically similar between the two groups. All episodes of pain (20% in the subconjunctival group and 6.6% in the peribulbar group) were rated as mild. Eye movement was more common in the subconjunctival group than in the peribulbar group, but it was controlled by verbal command and did not interfere with the procedure. No clinically significant complications occurred during surgery.
Subconjunctival anesthesia is an effective alternative to peribulbar anesthesia for trabeculectomy.
比较小梁切除术结膜下麻醉与球周麻醉的应用情况。
60例行小梁切除术的患者被前瞻性随机分为接受球周麻醉或结膜下麻醉两组。球周麻醉由在下方注射3毫升、上方注射1毫升2%甲哌卡因、0.75%布比卡因和透明质酸酶1:1混合液组成。结膜下麻醉由在颞上象限注射1至2毫升不含透明质酸酶的相同混合液组成。评估术中疼痛、眼球运动情况及手术并发症。
两组疼痛的频率和强度在统计学上相似。所有疼痛发作（结膜下组为20%，球周组为6.6%）均为轻度。结膜下组眼球运动比球周组更常见，但通过言语指令可控制，且不影响手术操作。手术期间未发生具有临床意义的并发症。
对于小梁切除术，结膜下麻醉是球周麻醉的一种有效替代方法。
