摘要
目的探讨球筋膜下麻醉在玻璃体视网膜手术中应用的安全性和有效性。方法162例（162只眼）行玻璃体视网膜手术患者，随机分为A、B两组，由同一术者分别给予球筋膜下麻醉（A组，81例）或球后麻醉（B组，81例）后，实施手术操作，通过视觉模拟评分法评价麻醉镇痛效果，并对患者合作度和麻醉并发症进行考察对比。结果162例患者在手术的四个阶段感觉无痛或轻度不适，平均疼痛评估分数如下：A组1．06±0．02，B组1．25±0．03。实施麻醉过程中A组（0．15±0．02）疼痛分数低于B组（1．04±0．03）。差异有统计学意义（19〈0．05）。手术过程中和术后0．5h、24h，两组患者疼痛评分差异无统计学意义（P〉0．05）。两组患者合作度较好或非常好的A组占88．9％，B组占87．7％，差异无统计学意义（P〉0．05）。A组多并发球结膜下出血，B组多并发眼睑水肿。结论球筋膜下麻醉过程中与球后麻醉相比患者疼痛较轻，手术过程中可达到良好的镇痛效果和满意的患者合作度，是一种安全有效且并发症少的玻璃体视网膜手术麻醉方法。
Objective To evaluate the safety and efficacy of sub-Tenon＇s anesthesia for vitreoretinal surgery.Methods 162 consecutive patients （ 162 eyes）who received the vitreoretinal surgery patients were received sub-Tenon＇s anesthesia（ group A, n=81 ）or retrobulbar anesthesia（group B, n=81 ）before the surgery.The patients were asked to grade their level of pain during different stages of the procedure using a standard 10-point visual analog scale.Patient cooperation and anesthesia complication were studied also.Results All patients reported no pain or slight discomfort during the whole surgery when received the sub-Tenon＇s anesthe- sia（overall mean score 1.06±0.02 ）, or retrobulbar anesthesia（overall mean score 1.25± 0.03 ）.Pain score during the process of anesthesia in group A（ 0.15± 0.02 ）was lower than group B （ 1.04± 0.03 ）, and the difference between groups was statistically significant.Patient cooperation was good or excellent in 88.9% patients of group A and 87.7% patients of group B.Complication of subconjunctival hemorrahage occurred significantly more frequently in group A,while eyelid edema occurred more frequently in group B.Conclusions Patients feel less painful when received sub-Tenon＇s anesthesia than retrobulbar anesthesia.Sub-Tenon＇s anesthesia could provide high level of pain control and patient cooperation, thus it was an safe and effective anesthesia method for vitreoretinal surgery.
出处
《中国实用眼科杂志》
CSCD
北大核心
2009年第4期344-347,共4页
Chinese Journal of Practical Ophthalmology
基金
国家自然科学基金资助项目（30700920）
北京市科技新星计划（B类）资助项目（2005B50）
关键词
球筋膜下麻醉
球后麻醉
玻璃体视网膜手术
suh-Tenon＇s anesthesia
Retrobulbar anesthesia
Vitreoretinal surgery.
作者简介
通信作者：张文一，Email：wen-yizhang@hotmail.com
