表面麻醉联合前房内麻醉对兔眼角膜内皮细胞的影响  

Effect of topical plus intraocluar lidocaine on corneal endothelial cells of rabbits

作　　者：曾波[1] 张晓农[1] 周和政[1] 

机构地区：[1]广州军区武汉总医院眼科,中国湖北省武汉市430070

出　　处：《国际眼科杂志》2006年第5期1035-1038,共4页International Eye Science

摘　　要：目的:观察不含防腐剂的利多卡因溶液行表面麻醉联合前房内麻醉的安全性。方法:使用角膜内皮镜观察联合麻醉下利多卡因溶液对角膜内皮细胞的影响,并观察组织学和超微结构改变。采用SPSS软件对数据行统计学处理。结果:联合麻醉后30,120min20g/L利多卡因组(C组)角膜内皮细胞变异系数(CV),六边形细胞比率(6A)与对照组(A组)比较有显著差异(C组vsA组,P<0.01),120min20g/L利多卡因组(C组)角膜内皮细胞密度(CD)、中央区角膜厚度与对照组(A组)比较有显著差异(C组vsA组,P<0.01)。光镜下见角膜内皮细胞肿胀,部分脱落,透射电镜示内质网肿胀。同期10g/L利多卡因组(B组)与对照组(A组)无显著差异(B组vsA组,P﹥0.05),光镜及透射电镜未见明显异常。结论:20g/L利多卡因表面麻醉联合10g/L利多卡因溶液前房内麻醉对兔眼角膜内皮细胞无明显毒副作用。联合麻醉下20g/L利多卡因对兔眼角膜内皮细胞有一定损害。AIM： To investigate the effect of using preservative-free lidocaine in topical plus intracameral anesthesia on corneal endothelial cells of rabbit eyes for phacoemulsification. METHODS： Thirty rabbits were divided into three groups： one control group and two experimental groups. All rabbits uderwent topical anesthesia with lidocaine 20g/L and paracentesis of anterior chamber. BBS 0.15mL was injected into rabbit anterior chamber in the Control group. Preservative-free lidocaine 10g/L and lidocaine 20g/L were administered to the rabbit anterior chamber in the two experimental groups, respectively. Specular microscopy was performed at 30 or 120 minutes. Histopathological examination and transmission electron microscopy （TEM） were performed after the rabbits were sacrificed at the same time. RESULTS： Specular microscopy assessment showed that the variation or the percent of hexagon of corneal endothelium cells had significant difference between the group of 20g/L lidocaine and the control group at 30 or 120 minutes, but the thickness, density of had significant difference only at 120 minutes. Edema and shedding of corneal endothelium cells were observed in histopathology. The endoplasmic edema was seen in TEM after lidocaine 20g/L was injected for 30 or 120 minutes, but the thickness, density, variation or the percent of hexagon of corneal endothelium cells in lidocaine 10g/L experimental groups showed no difference with those in the control group. Histopathology and TEM showed no abnormity. CONCLUSION： Intraocular injection of lOg/L preservative-free lidocaine is a safe anesthetic method for the topical anesthesia during phacoemulsification. Whereas intraocular injection of 20g/L preservative-free lidocaine has potential danger to corneal endothelium cells in rabbits.

关 键 词：前房内麻醉 利多卡因 角膜内皮细胞 动物实验 

分 类 号：R614[医药卫生—麻醉学]