上方球周麻醉联合表面麻醉白内障囊外摘除及人工晶状体植入术

Upper peribulbar anesthesia and topical anesthesia in ECCE and IOL implantation

目的:探讨上方球周麻醉联合表面麻醉白内障囊外摘除术的安全性及优越性。方法:选取2005-06/2008-12在我科接受白内障手术的患者,将所有患者随机分成3组,分别采用不同麻醉方式,手术方式均为白内障囊外摘除并植入后房型IOL,手术中观察麻醉效果,并术后随访3d观察视力和结膜反应。A组:上方球周麻醉联合表面麻醉(126眼);B组:上方结膜下浸润麻醉联合表面麻醉(89眼);C组:球后麻醉(86眼)。结果:三组全部286例301眼患者,手术全程均获得良好的麻醉效果。后囊破裂,A组和B组明显优于C组;术后结膜反应,A组和C组明显优于B组;术后视力,A组和B组明显优于C组。结论:上方球周麻醉联合表面麻醉白内障囊外摘除术是安全而优越的。

AIM：To estimate the safety and advantage of upper peribulbar anesthesia and topical anesthesia in extra capsular cataract extraction（ECCE） and intraocular lens（IOL） implantation. METHODS： All the 286 patients（301 eyes） with cataract from June 2005 to December 2008 were randomly assigned to three groups： group A（126 eyes） under upper peribulbar anesthesia and topical anesthesia; group B（89 eyes） under infra-conjunctival anesthesia;group C（86 eyes） under retrobulbar anesthesia. All the surgeries were under the microscope. The time of follow-up was 3 days. The effectiveness of anesthesia in operation, postoperative visual acuity and conjunctival reaction 3 days after operation were surveyed. RESULTS： The effectiveness of anesthesia in operation was good, these in group A and C were better than that in group B;postoperative visual acuities in group A and B were better than that in group C;conjunctival reaction in group A and group C were better than that in group B. CONCLUSION： ECCE and IOL implantation with upper peribulbar anesthesia and topical anesthesia is safe and superior to the infra-conjunctival anesthesia, topical anesthesia and retrobulbar anesthesia.