目的:本研究旨在确定巴西3种市售局部麻醉溶液的起效和持续时间,使用Cochet-Bonnet美度计(Luneau®,巴黎,法国)并定量评估患者报告的应用过程中的不适。方法:前瞻性,随机化,蒙面,进行了双盲研究,涉及21例患者的40只眼。患者每周服用一次局部麻醉药,使用Cochet-Bonnet美感仪的角膜接触阈值(CTT)测量角膜敏感性。患者使用视觉模拟量表(VAS)评估灼烧感。结果:21例患者中(42.9%为男性),平均年龄为31.95岁(±标准偏差=10.17,范围=22.0-58.0),应用后30s角膜敏感度显著下降,所有组均在30分钟后恢复至基线(P<0.0001)。在5分钟时观察到CTT的显着差异,丙美卡因表现出优异的麻醉效果(P=0.0003),在10分钟,其中丁卡因表现出最显著的麻醉效果(P=0.0135),20分钟时,其中丁卡因显示出最高的麻醉效果(P<0.0001)。VAS评分显示丁卡因烧灼感最强(P<0.0001)。与女性相比,男性报告在滴注过程中出现更多不适(P=0.0168)。结论:丙对卡因在3种局部麻醉药中表现出最快的起效,并在滴注过程中提供更舒适的眼睛感觉。然而,丁卡因表现出最长的作用持续时间,尽管引起更多的不适。
Purpose: This study aimed to determine the onset and duration of action of 3 commercially available topical anesthetic solutions in Brazil, using the Cochet-Bonnet esthesiometer (Luneau®, Paris, France) and to quantitatively assess patient-reported discomfort during application. Methods: A prospective, randomized, masked, and double-blind study was conducted, involving 40 eyes from 21 patients. Patients were administered each one of the topical anesthetics weekly, and corneal sensitivity was measured using the Cochet-Bonnet esthesiometer\'s corneal touch threshold (CTT). Patients rated the burning sensation using a visual analogue scale (VAS). Results: Among the 21 patients (42.9% male), with a mean age of 31.95 years (±standard deviation = 10.17, range = 22.0-58.0), corneal sensitivity significantly decreased 30 s after application, returning to baseline after 30 min for all groups (P < 0.0001). Significant differences in CTT were observed at 5 min, with proparacaine exhibiting a superior anesthetic effect (P = 0.0003), at 10 min, where tetracaine displayed the most substantial anesthetic effect (P = 0.0135), and at 20 min, where tetracaine demonstrated the highest anesthetic efficacy (P < 0.0001). VAS scores indicated the most intense burning sensation with tetracaine (P < 0.0001). Men reported experiencing more discomfort during instillation compared with women (P = 0.0168). Conclusions: Proparacaine exhibited the fastest onset of action among the 3 topical anesthetics and provided a more comfortable eye sensation during instillation. However, tetracaine demonstrated the longest duration of action despite causing more discomfort.