四种局麻方式对Phaco患者眼压变化的观察

Effects of four kinds of local anesthesia on intraocular pressure in eyes undergoing Phaco

为对比评价四种方式局麻与眼压变化的关系。方法 :连续性选取 6 0例老年性白内障 PEA+ IOL住院手术患者 ,随机分至球后、球周、角膜缘球结膜下及表面麻醉组。分别于麻醉前、麻醉后、麻醉后 5分钟及 10分钟用非接触式眼压计测量眼压。结果 :球后及球周组在麻醉后眼压较麻醉前均升高 ,结膜下组与表麻组未见显著差异。各种麻醉技术之间对比结果显示 ,球后组与球周组对麻醉前后眼压影响在麻醉后及 5 min后差异有显著性 ,球后组眼压增高较小 ,降低较快 ;10 min后差异不显著。球后组较结膜下和表麻组眼压在麻醉后升高 ,10 min后降低 ,球周组较结膜下组及表麻组在麻醉后及 5 min时均高 ,10 min时差异不显著。结膜下组与表麻组始终无显著差异。结论 :球后及球周麻醉较结膜下及表面麻醉前后的眼压变化大 ,且个体眼压反应有很大差异 。

To investigate the effect on intraocular pressure(IOP)of four finds of local anesthesia in eyes undergoing Phaco.Methods:A total of 60 eyes were studied.They were randomized to four groups:retrobulbar anesthesia,peribulbar anesthesia,subconjunstival anesthesia and topical anesthesia group.Intraocular pressure was measured before,immediately after,and 5 and 10 minutes after anesthesia by non contact tonometer.Result:The mean IOP after anesthesia rose significantly in group I and 2,but not in group 3 and 4.By comparison,the mean rose of group 1 was smaller than group 2 immediately after and 5 minutes after anethesia,but the same 10 minutes after.The mean IOP increase of group 1 immediately after,and 5 minutes after anesthesia,and the decrease 10 minutes after were statisically significant different with group 3 and 4.The mean IOP in crease of group 2 immediately after,and 5 minutes after anesthesia were significant different with group 3 and 4,but had no significant difference 10 minutes after.There were not significant difference between group 3 and 4.Conclusions:The mean IOP change in retrobulbar aneshesia and peribulbar anesthesia with ocular compreeession was much more than in subconjunstival anesthesia and topical anesthesia,and had individual difference.