作者:Norman A. Zabriskie、Iqbal Ike K. Ahmed、Alan S. Crandall、Brad Daines、Thomas A. Burns、Bhupendra C. K. Patel
DOI:10.1097/00061198-200208000-00006
日期:2002.8
Purpose
To compare the safety and efficacy of topical versus retrobulbar anesthesia for primary trabeculectomy
Methods
A prospective study of 36 consecutive patients undergoing trabeculectomy who were randomized to receive topical (n = 18) or retrobulbar (n = 18) anesthesia. Operating conditions, patient comfort, and surgical outcome were evaluated.
Settings
Tertiary-care university hospital ambulatory surgical center.
Results
There were no differences in operating conditions (P = 0.14), pain during (P = 0.54) or after (P = 0.76) surgery, or supplemental anesthesia required (P = 0.34) between the two groups. Very few patients in either group were bothered by touch sensation, tissue manipulation, or the microscope light. Chemosis, subconjunctival hemorrhage and eyelid hemorrhage were seen exclusively in the retrobulbar group (P <0.03), and were all attributable to the injection. Inadvertent eye movement was present more frequently in the topical group (P = 0.01), although this did not pose a problem to the surgeon. No surgical complications were encountered in either group.
Conclusion
Topical anesthesia is a safe and effective alternative to retrobulbar anesthesia for primary trabeculectomy.
目的 比较初级小梁切除术中局部麻醉与球后麻醉的安全性和有效性 方法 对连续接受小梁切除术的 36 名患者进行前瞻性研究,随机分配患者接受局部麻醉(18 人)或球后麻醉(18 人)。对手术条件、患者舒适度和手术结果进行了评估。 地点 大学附属医院门诊手术中心。 结果 两组患者在手术条件(P = 0.14)、术中疼痛(P = 0.54)或术后疼痛(P = 0.76)以及所需的辅助麻醉(P = 0.34)方面均无差异。两组患者中只有极少数人对触觉、组织操作或显微镜光线感到不适。化脓、结膜下出血和眼睑出血仅见于球后组患者(P <0.03),且均可归因于注射。局部注射组出现眼球意外移动的频率更高(P = 0.01),不过这并没有给外科医生造成困扰。两组患者均未出现手术并发症。 结论 局部麻醉是初级小梁切除术中球后麻醉的一种安全有效的替代方法。