初发性翼状胬肉术中单用利多卡因凝胶与丁卡因滴液表面麻醉效果对比分析  

Comparation of the effectiveness of lidocaine gel versus tetracaine drops as the sole topical anaesthetic agent for primary pterygium surgery

作　　者：邓莹莹[1,2] 邢怡桥[1] 许玲[2] 王玲丽[2] 

机构地区：[1]武汉大学人民医院眼科,44200 [2]湖北医药学院附属太和医院眼科

出　　处：《临床眼科杂志》2013年第1期72-74,共3页Journal of Clinical Ophthalmology

摘　　要：目的评价2%利多卡因凝胶与1%丁卡因滴液在初发性翼状胬肉手术中的有效性。方法对手术切除的初发性翼状胬肉150例(150只眼)进行回顾性随机对照研究。翼状胬肉切除同时联合丝裂霉素C治疗。患者随机分成两组。第一组用1%丁卡因滴液。第二组用2%盐酸利多卡因凝胶和0.9%生理盐水滴液。术前疼痛患者均用丁卡因滴液。主要观察患者术中术后疼痛情况。患者和医生术后即分别用10分线型类比量表进行疼痛和不适评估。手术分4步:(1)切开;(2)翼状胬肉切除;(3)结膜缝合;(4)修补。结果翼状胬肉切除过程中(第2步)患者平均疼痛评分差异无统计学意义(利多卡因组和丁卡因组分别为3.58±2.20和3.88±2.16)。而在第3步,结膜缝合结膜期间平均疼痛评分差异有统计学意义(P=0.029,利多卡因组和丁卡因组分别为1.22±0.65和2.26±1.50),第二组患者疼痛轻。利多卡因凝胶组需额外滴液的平均次数(0.54±0.10)也显著低于丁卡因组(1.06±0.19,P=0.001)。结论 2%利多卡因凝胶和1%丁卡因滴液都是初发性翼状胬肉手术中应用有效的表面麻醉药物,但利多卡因凝胶比丁卡因滴液应用更方便,不需频繁使用,作用时间长。Objective To compare the analgesic effect of lidocaine 2% gel vs. tetracaine 1% drops in primary pterygium surgery. Methods This is a prospective, randomized controlled trial. One hlmdred and fifty patients who un- derwent surgical excision and mitomycin C for primary pterygium were recruited. Patients were randomly assigned into two groups. Group 1 received tetracaine 1% drops and group 2 received xyloca/ne 2% gel with normal saline drops. All pa- tients who experienced pain preoperatively were given tetracaine drops. The primary outcome was the pain experienced dur- ing and after surgery. Pain and discomfort was assessed using a 10-point linear analogue scale immediately after the surger- y. Surgical procedures included 4 steps ： initial incision （ step 1 ）, pterygium body excision （ step 2 ）, conjunctival suturing （ step 3 ）, and patching （ step 4 ）. Results There was no significant difference in the mean pain scores experienced during pterygium excision （3.58 ± 2.20 for the lidocaine group and 3.88 ± 2.16 for the tetracaine group）. However, there was a significant difference in mean pain scores experienced at third step of the surgery （ i. e, conjunctival suturing; P = 0.029 ） between lidocaine gel group （ 1.22 ± 0.65 ） and tetracaine group （2.66± 1.50 ）, with patients of group 2 experienced less pain. Additional eye drop administrations required in lidocaine gel group were also significantly less in lidocaine gel group 0.54± 0. 10） than in tetracaine group （ 1.06± 0. 19, P = 0.001）. Conclusion Topical administration of lidocaine 2% gel or tetracaine 1% drops are both effective anesthetic methods for primary pterygium surgery. However, lidocaine gel is superior to tetracaine eye drops. It is more convenient, requires less application, and imposes a longer duration of action.

关 键 词：初发性翼状胬肉 利多卡因凝胶 丝裂霉素C 丁卡因滴液局部麻醉 

分 类 号：R614[医药卫生—麻醉学]