不同麻醉方式对眼压和眼脉动振幅的影响

The influence of different anesthetic modes on intraocular pressure and ocular pulse amplitude.

目的比较球后麻醉和眼球筋膜囊下麻醉对眼压及眼脉动振幅（OPA）的影响。方法顺贯性选择单眼白内障40例，分别作球后麻醉和眼球筋膜囊下麻醉（各20例）。术眼为试验组，另眼设为对照。分别于麻醉前及麻醉后1min、10min采用轮廓动态眼压计（DCT）测量眼压及OPA。结果注射利多卡因后球后麻醉组注射眼的眼压升高。眼球筋膜囊下麻醉注射眼和对照眼的眼压均无明显变化。两组注射眼OPA值均显著降低，眼球筋膜囊下麻醉后10min对照眼OPA值降低，球后麻醉后1min对照眼OPA值升高，10min后恢复至注射前水平。结论球后麻醉可降低眼脉动振幅，使眼压升高；眼球筋膜囊下麻醉降低眼脉动振幅，对眼压则无明显影响。

Objective To compare the influence of retrobulbar and sub-Tenon＇ s anesthesia on intraoeular pressure （lOP） and ocular pulse amplitude （OPA）. Methods Forty consecutive adult patients with monocular cataract were enrolled in this study and were divided into retrobulbar and sub-Tenon＇ s group, lOP and OPA were measured with dynamic contour tonometer （DCT） in the operated eye and in the eontralateral eye as a control before and at 1 minute and 10 minutes after administration of lidoeaine anesthesia. Results With retrobulbar anesthesia, the lOP increased ill the injected eyes while no significant change was observed in the control eyes; The lOP remained stable in both eyes with sub-Tenon＇ s anesthesia. The OPA significantly decreased in the injected eyes with both modes anesthesia after injection of anesthetie agents. The decrease of OPA in the sub - Tenon＇s group was detected after 10 minutes in the control eyes. In the retrobulbar anesthesia group,the OPA in the control eyes increased signiticantly at 1 minute after injection and returned to preinjeetion levels at 10 minutes after injection. Conclusion Retrobulbar anesthesia decreases OPA and increases （IOP）. Sub-Tenon＇s anesthesia reduces OPA and has no obvious influence on IOP.