Roux L, Rigal-Sastourné J C, Bidaux F, May F, Renard J P, Maurin J F
Clinique d'Ophtalmologie, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris.
J Fr Ophtalmol. 1998 Apr;21(4):257-63.
To evaluate the advantage of intracameral unpreserved lidocaine for patient comfort during phacoemulsification under topical anesthesia.
In this prospective study, we performed 80 phacoemulsifications under topical anesthesia, with tetracaine 1% drops, 10 minutes before and at the start of surgery: 40 patients received 0.3 cc balanced salt solution (BSS) intracameral injection; 40 patients received 0.3 cc unpreserved lidocaine 1% intracameral injection. The same surgical procedure was performed in both groups: 3.2 mm temporal corneal self-sealing incision, capsulorhexis, foldable polyHEMA IOL implantation into the capsular bag. There was no intravenous sedation.
Forty-eight percent (19) in the BSS group and 70% (28) in the lidocaine group felt no pain. 10% (4) in the BSS group reported sharp pain during phacoemulsification. During IOL insertion, no pain was reported by 48% (19) in the BSS group, and 75% (30) in the lidocaine group; 10% (4) in the BSS group felt severe pain (significant difference: p < 0.05). Endothelial cell loss was 6% in the BSS group, and 6.4% in the lidocaine group (non significant difference).
Intracameral lidocaine is safe and effective in decreasing discomfort among patients undergoing phacoemulsification under topical anesthesia.
评估前房内注射未保存的利多卡因在表面麻醉下白内障超声乳化手术中提高患者舒适度的优势。
在这项前瞻性研究中，我们对80例接受表面麻醉的患者进行了白内障超声乳化手术，术前10分钟及手术开始时滴入1%丁卡因滴眼液：40例患者接受前房内注射0.3 cc平衡盐溶液（BSS）；40例患者接受前房内注射0.3 cc未保存的1%利多卡因。两组均采用相同的手术步骤：颞侧角膜3.2 mm自闭式切口、连续环形撕囊、将可折叠式聚甲基丙烯酸羟乙酯人工晶状体植入囊袋内。术中未使用静脉镇静剂。
BSS组48%（19例）和利多卡因组70%（28例）患者无疼痛感。BSS组10%（4例）患者在超声乳化过程中报告有剧痛。在人工晶状体植入过程中，BSS组48%（19例）和利多卡因组75%（30例）患者无疼痛感；BSS组10%（4例）患者感到剧痛（差异有统计学意义：p < 0.05）。BSS组内皮细胞损失率为6%，利多卡因组为6.4%（差异无统计学意义）。
前房内注射利多卡因在表面麻醉下白内障超声乳化手术中减轻患者不适方面安全有效。
