筋膜下麻醉小梁切除术

Trabeculectomy under sub-fascial anesthesia

目的:探讨筋膜下麻醉行小梁切除术的有效性及安全性。方法:在连续58例(60眼)青光眼小梁切除术中分别应用表面麻醉、球后麻醉、筋膜下麻醉各20眼,观察麻醉效果、并发症情况。结果:表面麻醉组患者术中在上直肌牵引缝线、巩膜电凝、周边虹膜切除、结膜缝合时有不同程度痛感,筋膜下麻醉、球后麻醉组患者术中无明显痛感,筋膜下麻醉组1眼、球后麻醉组2眼术中出现一过性黑矇,球后麻醉组术中出现球后出血1眼,术后短暂性上睑下垂2眼。结论:小梁切除术采用筋膜下麻醉具有麻醉效果好、并发症少的优点,是理想麻醉方法。

AIM ： To evaluate the safety and efficiency of sub-fascial anesthesia for trabeculectomy. METHODS： Fifty-eight cases （60 eyes） underwent glaucoma trabeculectomy were randomly divided into 3 groups, topical anesthesia group, retrobulbar anesthesia group and subascial anesthesia group （20 eyes in each group）. Pain during surgery and postoperative complications were analyzed. RESULTS： In topical anesthesia group, sense of pain was appear during superior rectus traction suturing in 20 eyes （100%）, sclera coagulation in 20 eyes （100%）, iridectomy in 3 eyes （15%）, and conjunctival flaps suturing in 13 eyes （65%） . Patients did not feel pain during surgery in retrobulbar anesthesia group and sub-fascial anesthesia group. Retrobulbar bleeding presented in 1 eye, temporary ptosis in 2 eyes, and temporary vision lose in 2 eyes in retrobulbar anesthesia group. Temporary vision losing occurred in sub-fascial anesthesia group on 1 eye. CONCLUSION： Trabeculectomy under sub-fascial anesthesia is a safe and efficient method with less complication.