Sanford D K, Minoso y de Cal O E, Belyea D A
Ophthalmology Service, Walter Reed Army Medical Center, Washington, DC, USA.
Ophthalmic Surg Lasers. 1998 Oct;29(10):815-7.
To evaluate the response of intraocular pressure (IOP) to retrobulbar and peribulbar anesthesia.
Patients were prospectively masked and randomized to receive either 4 cc of retrobulbar anesthesia (X = 29) or 6 cc of peribulbar anesthesia (X = 30), each consisting of a 50:50 mixture of 2% xylocaine and 0.75% bupivacaine with 150 units of hyaluronidase. IOPs were measured pre-anesthesia and 1, 2, and 5 minutes post-anesthesia in nonglaucoma patients undergoing cataract extraction and intraocular lens implantation.
Mean IOPs in the retrobulbar group as determined with a tonometer were 18.24, 18.66, 19.14, and 17.86 mm Hg pre-anesthesia and 1, 2, and 5 minutes post-anesthesia, respectively. In the peribulbar group, the mean IOPs were 18.53, 21.20, 20.40, and 19.20 mm Hg, respectively. The 1-minute pressures in the two groups were statistically different (P = .023). Within the peribulbar group, the 1- and 2-minute pressures were statistically different from the pre-anesthesia IOP (P = .001 and P = .018, respectively).
Peribulbar anesthesia, with its higher volume of anesthetic (6 vs 4 cc), results in a higher initial IOP. This difference was slight and short lived, and occurred in the absence of any external ocular compression. This study may have application in avoiding elevation of IOP in select patients undergoing a local procedure.
评估球后麻醉和球周麻醉对眼压（IOP）的影响。
前瞻性地对患者进行遮蔽并随机分组，分别接受4毫升球后麻醉（X = 29）或6毫升球周麻醉（X = 30），每种麻醉均由2%利多卡因和0.75%布比卡因与150单位透明质酸酶按50:50混合而成。对接受白内障摘除和人工晶状体植入的非青光眼患者在麻醉前以及麻醉后1、2和5分钟测量眼压。
使用眼压计测定，球后组麻醉前及麻醉后1、2和5分钟的平均眼压分别为18.24、18.66、19.14和17.86毫米汞柱。球周组的平均眼压分别为18.53、21.20、20.40和19.20毫米汞柱。两组的1分钟眼压在统计学上存在差异（P = .023）。在球周组内，1分钟和2分钟眼压与麻醉前眼压在统计学上存在差异（分别为P = .001和P = .018）。
球周麻醉使用的麻醉剂体积更大（6毫升对4毫升），会导致初始眼压更高。这种差异轻微且持续时间短，并且是在没有任何眼球外部压迫的情况下出现的。本研究可能有助于避免特定接受局部手术患者的眼压升高。
