Hyaluronidase in sub-Tenon's anesthesia for phacoemulsification,a double-blind randomized clinical trial

AIM:To investigate the effect of hyaluronidase use on the quality of sub-Tenon's anaesthesia for phacoemulsification.· METHODS:This was a randomized,double-blind clinical trial which was conducted at Nikookari Eye Hospital for 5 months.Forty-two eyes of candidates for phacoemulsification under sub-Tenon's anaesthesia were randomly allocated to two equal groups and received either 2 mL of lidocaine 2% solution with(LH),or without(L) addition of hyaluronidase(150IU/mL).Akinesia was assessed 15 minutes after sub-Tenon's injection.Patients and surgeon's satisfaction,as well as the postoperative pain(the visual analogue scale,VAS) were investigated after operation.The contingency tables(including the Chi-square or Fisher's exact tests,when appropriate) and parametric analysis(the independent samples t test) were used for statistical analysis.· RESULTS:Complete akinesia(33.3% vs 4.8%,P =0.04),as well as the patients(85.7% vs 57.1%,P =0.04)and surgeon's satisfaction(87.5% vs 52.4%,P =0.02) were significantly more frequent in LH than in L group.The mean VAS was significantly lower in the same group(1.90±1.45 vs 3.00±1.55,P =0.04).· CONCLUSION:Addition of hyaluronidase to lidocaine solution for sub-Tenon's anesthesia significantly improves the ocular akinesia,enhances the intra-operative patients and surgeons' satisfaction,and attenuates the postoperative pain.·

超声乳化术中透明质酸酶在筋膜下麻醉中的应用(英文)

目的:探讨超声乳化术中透明质酸酶对筋膜下麻醉的疗效。方法:该研究是一项双盲随机临床试验,在Nikookari眼科医院进行了长达5mo。行超声乳化术的候选患者中接受筋膜下麻醉的42眼随机分为均等的两组,分别应用 20g/L的利多卡因溶液2mL+150U/mL透明质酸酶(LH),和单纯20g/L的利多卡因溶液2mL( L)。筋膜下注射15min 后活动受抑制。患者和医生都非常满意,对于术后疼痛的抑制(视觉模拟评分,the visual analogue scale,VAS) 也同样满意。统计学分析采用列联表(包括卡方检验或 Fisher's精确检验) 和参数分析(独立样本t检验)。结果:活动抑制(33.3%vs4.8%,P=0.04)、患者满意度(85.7%vs57.1%,P=0.04)和医生满意度(87.5% vs52.4%,P=0.02),LH组明显高于L组。VAS在相同组内明显较低(1.90±1.45vs3.00±1.55,P=0.04)。结论:利多卡因溶液+透明质酸酶的筋膜下麻醉明显使得眼部活动受限,提高了患者和医生的满意度,并减轻了术后疼痛。