盐酸丁氧普罗卡因的表面麻醉作用及其对角膜的影响  

Topical anaesthetic effect of oxybuprocaine and it's effects on cornea

作　　者：黄昌雪[1] 王平[1] 臧萍[1] 梁山[1] 刘育霞[1] 李勤新[1] 田秀慧[1] 

机构地区：[1]潍坊医学院附属医院眼科中心,山东省潍坊市261031

出　　处：《眼科新进展》2006年第10期770-771,共2页Recent Advances in Ophthalmology

摘　　要：目的观察盐酸丁氧普罗卡因对角膜表面麻醉作用的特点、优缺点及其对角膜的影响。方法应用4g.L-1盐酸丁氧普罗卡因进行眼科检查,棉丝触压角膜知觉检查法观察局麻药的表面麻醉作用,滴药前后用角膜荧光素染色观察角膜变化并对角膜地形图进行对比分析。用30g.L-1洁霉素和10g.L-1地卡因滴眼液作为对照。结果盐酸丁氧普罗卡因和地卡因表面麻醉生效时间分别为(20±5)s和(6±2)min,2组间有显著性差异(P<0.01);角膜荧光素染色结果显示,滴盐酸丁氧普罗卡因98眼中,仅10眼出现角膜少量细点状着色,无角膜内皮水肿;而滴地卡因98眼中,20眼角膜大片染色,21眼细点状染色,26眼出现角膜内皮水肿,二者有显著性差异(P<0.01);滴药后角膜地形图变化率,洁霉素为3.06%,盐酸丁氧普罗卡因为61.22%,地卡因组82.65%,后2者与洁霉素组比较差异有显著性(P<0.01)。结论多次、不合理应用表面麻醉剂可对眼表造成毒性损伤,盐酸丁氧普罗卡因具有麻醉作用迅速、安全、角膜毒副作用少的优点,值得在临床上推广使用。Objective To observe the topical anaesthetic effect of oxybuprocaine and its effects on cornea. Methods Ophthalmological examination was performed by 4 g·L^-1 oxybuproeaine and the topical anaesthetic effect of oxybuprocaine on cornea was observed by stimulating cornea. The changes of cornea were observed by dyeing cornea with luciferin and the corneal topography was compared and analyzed at pre-using drops and post-using drops. 30 g·L^-1 lincomycin and 10 g·L^-1 dicaine were set as control. Resuits The onset of anaesthetic effect of oxybuprocaine group and dicaine group were （20 ± 5） seconds and （6 ±2） minutes respectively. There was a significant difference between two groups （P 〈 0.01 ）. Luciferin dyeing of cornea showed： 10 eyes appeared minute dot pigmentation in oxybuprocaine group （10.4%） without corneal endothelium edema. Whereas,in dicaine group, 20 eyes appeared big patch pigmentation, 21 eyes appeared minute dot pigmentation,and 26 eyes appeared corneal endothelium edema. There was a significant difference between two groups （P 〈 0.01 ）. The corneal topography changing rate after using drops： 30 g·L^-1 lincomycin group was 3.06 %, 4 g·L^-1 oxybuprocaine group was 61.22 %, and 10 g·L^-1 dicaine group was 82.65%. There was a significant difference between oxybuprocaine group, dicaine group and lincomycin group（P 〈 0.01 ）. Conclusion Toxicity to ocular surface will occur if the topical anesthetics is abused. Oxybuprocaine is characterized by significant safety, few side effect, so it should be extended clinically.

关 键 词：盐酸丁氧普罗卡因 角膜 表面麻醉 角膜地形图 

分 类 号：R772.2[医药卫生—眼科] R771.2[医药卫生—临床医学]