改良球筋膜囊下麻醉在玻璃体切割术中的应用  

Improved sub-Tenon＇s anesthesia in vitrectomy operation

作　　者：张鹏[1] 李丹[2] 章剑[1] 章政[1] 陈金鹏[1] 徐辉勇[1] 

机构地区：[1]武汉大学医学院鄂州市第一医院眼科,湖北鄂州436000 [2]武汉大学医学院鄂州市第一医院麻醉科,湖北鄂州436000

出　　处：《中国实用眼科杂志》2013年第4期454-456,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨改良球筋膜囊下麻醉在玻璃体切割手术中的临床效果、安全性及作用机制。方法选取需行玻璃体切割手术的患者60例（60只眼）随机分为两组，试验组（30例）应用改良球筋膜囊下麻醉，对照组（30例）采用球后阻滞麻醉，再行玻璃体切割术，采用NRS-11（the11-pointnumericratingscale，NRS-11）观测做巩膜切口、眼内操作及结束时受术者的疼痛程度并记录分析。结果巩膜切口、眼内操作及结束时试验组NRS-11评分差异无统计学意义（P〉0．05）；试验组不良反应球结膜水肿为主（23．33％），对照组不良反应以眶内压增高8例为主（26．77％）。结论改良球筋膜囊下麻醉可获得与球后阻滞麻醉相同的麻醉镇痛效果，患者对手术效果的满意，是一种安全、有效、并发症少的麻醉方法。Objective To study the effect, safety and mechanism of improved Sub-Tenon＇s anes- thesia in vitrectomy operation. Methods Sixty patients were randomly assigned into two groups which were received improved Sub-Tenon＇s anesthesia or retrobulbar anesthesia in vitrectomy opera- tion. The degrees of pain were evaluated by the ll-point numeric rating scale （NRS-11） at the begin- ning and the end of the operation. Adverse effects and the overall satisfaction on analgesic therapy were assessed when operation finished. Results The difference of the NRS-11 scores between groups was not statistically significant at the beginning and the end of operation （P 〉0.05）. Bulbar conjunctiva edema occurred more frequently in experimental group, while intraorbital pressure in- crease occurred more frequently in control group. Conclusions Improved sub-Tenon＇s anesthesia can provide high level of pain control and patient cooperation, and it is a safe and effective anesthe- sia methods.

关 键 词：改良球筋膜囊下麻醉 球后阻滞麻醉 玻璃体切割手术 

分 类 号：R779.6[医药卫生—眼科]