目的:Sub-Tenon麻醉是一种用于眼科手术的局部麻醉技术,尤其是白内障手术。在我们的环境中,很少有研究报道Tenon下麻醉对运动障碍和镇痛的影响以及有效镇痛和运动障碍所需的最佳麻醉剂量。这项研究的目的是确定和比较在伊洛林大学教学医院(UITH)预订接受白内障手术的患者中,Tenon下注射2mL和3mL西洛卡因后的镇痛和运动障碍水平以及眼部按压的效果。
方法:对2017年3月至2017年8月在UITH眼科预约手术的白内障患者进行了横断面比较研究。总共200名符合纳入标准的白内障患者被招募到6个月的研究中。预约手术的白内障患者名单构成了抽样框架。进行问卷调查以获取有关社会人口统计学的信息,眼部症状,和其他历史。检查了视力,用笔炬进行眼部检查,检眼镜,用78D进行裂隙灯检查。进行眼压和视神经评估以排除任何先前存在的青光眼或可疑椎间盘的患者。将约200例患者随机分为两个容量组之一(第1组使用2mL的Tenon-xylocaine注射液,而第2组使用3mL);12分钟和15分钟检查镇痛和运动障碍的水平,分别。
结果:年龄范围为20-107岁;第1组的平均年龄为63.8±12.64,而第2组的平均年龄为64.14±14.14。M:f为1:1.4时,女性占少数,超过一半的患者出现右眼(RE)白内障。Tenon下注射后12分钟,两组的镇痛水平相似。然而,第1组中有2例患者出现剧烈疼痛,第2组中无患者出现剧烈疼痛.发现两组在注射后15分钟评估的运动障碍水平在第2组中明显更好。
结论:有轻微的女性优势,大约三分之二的患者是女性,没有疼痛的女性比例高于男性,超过50%的患者患有RE性白内障.无论是2mL还是3mL,Tenon下麻醉都会导致眶内压(IOP)的统计学显着升高;然而,眼睛压迫,发现两组的IOP均下降至低于注射前压力.两组的镇痛水平相似,而在注射3mL的组中,运动障碍在统计学上更好。
OBJECTIVE: Sub-Tenon anesthesia is a form of local anesthetic techniques used in ophthalmic procedures, especially in cataract surgery. Few studies in our environment have reported the effects of sub-Tenon anesthesia on
akinesia and analgesia as well as optimum volumes of anesthetic agents that are required for effective analgesia and
akinesia. The objective of this study is to determine and compare the level of analgesia and
akinesia and the effect of ocular compressions after sub-Tenon injection of 2 mL versus 3 mL of xylocaine among patients booked for cataract surgery in the University of Ilorin Teaching Hospital (UITH).
METHODS: A cross-sectional comparative study among cataract patients booked for surgery in the Department of Ophthalmology at UITH was carried out from March 2017 to August 2017. A total of 200 cataract patients that met the inclusion criteria were recruited into the study over 6 months. Lists of cataract patients booked for surgery formed the sampling frame. Questionnaires were administered to obtain information on sociodemographic, ocular symptoms, and other histories. Visual acuity was checked, and ocular examination was done with a pen-torch, ophthalmoscope, and slit-lamp examination with 78D. Tonometry and optic nerve assessments were done to exclude any patient with preexisting glaucoma or suspicious disc. About 200 patients were randomly allocated into one of two volume groups (Group 1 had 2 mL sub-Tenon xylocaine injection whereas Group 2 had 3 mL); level of analgesia and akinesia was checked 12 min and 15 min, respectively.
RESULTS: The age range was 20-107 years; mean age for Group 1 was 63.8 ± 12.64, whereas the mean age of Group 2 was 64.14 ± 14.14. There was a slight female preponderance given a M:f of 1:1.4 and more than half of the patients presented with right eye (RE) cataract. Levels of analgesia 12 min after sub-Tenon injections in both groups were similar. However, two patients were found to have severe pain in Group 1, and no patients had severe pain in Group 2. The level of
akinesia which was assessed 15 min after injection in both groups was found to be significantly better in Group 2.
CONCLUSIONS: There was a slight female preponderance with about two-third of the total patients being female and the percentage of females who had no pain was more than the male, more than 50% of the patients had RE cataracts. Sub-Tenon anesthesia whether with 2 mL or 3 mL led to a statistically significant rise in intraorbital pressure (IOP); however, with ocular compression, the IOP was found to decrease below the preinjection pressure in both groups. Levels of analgesia were similar in the two groups, whereas
akinesia was statistically better in the group that had 3 mL injection.