Hulbert M F, Yang Y C, Pennefather P M, Moore J K
Arrowe Park Hospital, Wirral, Merseyside, United Kingdom.
J Glaucoma. 1998 Dec;7(6):413-6.
To assess the influence of adrenaline and hyaluronidase on pulsatile ocular blood flow and intraocular pressure changes during retrobulbar anesthesia.
Patients undergoing cataract surgery under local anesthesia received a 5-mL retrobulbar injection of lignocaine with either adrenaline, hyaluronidase, or no addition. Continuous pneumotonometry was performed using the OBF tonograph (OBF Labs, Chippenham, UK), which automatically derives pulsatile ocular blood flow values. Measurements were taken before and one minute after injection, and changes were compared between groups to evaluate the effects of changing the constituents of the injection.
There was a marked decrease in pulsatile ocular blood flow during injection in all groups. In the group receiving lignocaine with hyaluronidase, the decrease in pulsatile ocular blood flow (mean -141 microL/min) was significantly less than in either the group receiving lignocaine and adrenaline (mean -249 microL/min) or the group receiving lignocaine alone (mean -245 microL/min). There was no significant change in intraocular pressure in any group.
Hyaluronidase appears to lessen the reduction in pulsatile ocular blood flow. Injection volumes of 5 mL need not cause significant intraocular pressure change.
评估肾上腺素和透明质酸酶对球后麻醉期间搏动性眼血流和眼压变化的影响。
接受局部麻醉下白内障手术的患者接受5毫升球后注射，注射药物为含肾上腺素的利多卡因、含透明质酸酶的利多卡因或未添加其他成分的利多卡因。使用OBF眼压描记仪（OBF Labs，英国奇彭纳姆）进行连续气压眼压测量，该仪器可自动得出搏动性眼血流值。在注射前和注射后1分钟进行测量，并比较各组之间的变化，以评估改变注射成分的效果。
所有组在注射期间搏动性眼血流均显著下降。在接受含透明质酸酶利多卡因的组中，搏动性眼血流的下降（平均-141微升/分钟）明显小于接受含肾上腺素利多卡因的组（平均-249微升/分钟）或仅接受利多卡因的组（平均-245微升/分钟）。任何组的眼压均无显著变化。
透明质酸酶似乎可减轻搏动性眼血流的减少。5毫升的注射量不会引起显著的眼压变化。
