局部麻醉对兔眼心反射和眼角膜愈合的影响(英文)

Influence of topical anesthetics on oculocardiac reflex and corneal healing in rabbits

目的:在兔模型中利用局部麻醉来研究两种麻醉剂的眼心反射发生率及其预防,同时我们还研究了局部麻醉对角膜愈合的影响。方法:健康的成年新西兰白兔(雌雄皆有)48只,分成两组(A组和B组),分别用氯胺酮(A组,24例)、异丙酚(B组,24例)麻醉。在此双盲研究中,通过用或不用局部麻醉(40g/L利多卡因,5g/L盐酸丙美卡因,5g/L布比卡因)对眼睛的不同干预,记录各组眼心反射发生率。应用每种局部麻醉后,通过对眼睛的临床检查,组织病理学,胶原染色以及投射电子显微等方法对术后1d长达7d角膜毒性和愈合进行评估。结果:在氯胺酮的麻醉下未出现眼心反射,而在异丙酚的麻醉下,心率显著下降(P<0.01)。因此,局部麻醉可以成功地防止眼心反射的发生并且不影响角膜愈合。结论:局部麻醉没有任何局部副作用,可以被推荐用来预防眼心反射。

AIM ： To investigate the incidence of oculocardiac reflex （OCR） with two anesthetic regimens and its prevention using topical anesthetics in a rabbit model. We also investigated the effect of topical anesthetics on corneal healing.METHODS. Forty-eight clinically healthy adult New Zealand white rabbits of either sex were divided into two groups （Group A and B） and anesthetized with either ketamine （Group A, n = 24） or propofol （Group B, n = 24）. In this study , the incidence of OCR was recorded in each group with a variety of ocular manipulation with or without the use of topical anesthetics （40g/L lignocaine, 5g/L proparacain, 5g/L bupivacaine）. Corneal toxicity and healing following the use of each topical anesthetic was assessed one day after surgery and up to 7 days postoperativety by clinicat examination of the eye, histopathology and collagen staining and transmission electron microscopy.RESULTS： No incidence of OCR was recorded with ocular manipulation under ketamine anesthesia, whereas significant reduction in heart rate （P〈0.01） was recorded under propofol anesthesia. Topical anesthetics could successfully prevent the OCR without affecting the corneal healing.CONCLUSION. Topical anesthetics may be recommended for prevention of OCR without any local adverse effect.