罗哌卡因利多卡因混合液眼球筋膜囊下麻醉在斜视手术中的应用研究  

Study on the clinical efficacy of sub-tenon anesthesia using a ropivacaine and lidocaine mixture for strabismus surgery

作　　者：曾思明[1] 徐帆[1] 

机构地区：[1]广西壮族自治区人民医院眼科,中国广西壮族自治区南宁市530021

出　　处：《国际眼科杂志》2014年第4期774-776,共3页International Eye Science

摘　　要：目的:评价罗哌卡因利多卡因混合液眼球筋膜囊下麻醉在斜视手术中应用的优越性。方法:选择80例局部麻醉手术的水平性斜视患者,分为试验组和对照组,用7.5g/L罗哌卡因混合20g/L利多卡因分别作眼球筋膜囊下麻醉和结膜下浸润麻醉,并进行疼痛和眼心反射的评估。结果:患者80例均能在局部麻醉下顺利完成手术,疼痛的评估结果:根据视觉模拟评分法(VAS),试验组评为"优"者12例,"良"者21例,"可"者6例,"差"1例。对照组"优"者2例,"良"者25例,"可"者12例,"差"1例。两组进行秩和检验,P<0.01,两组有显著差异。术中牵拉眼内外直肌数量和出现眼心反射情况为:试验组牵拉肌肉共74条,发生眼心反射26次,对照组牵拉肌肉共76条,发生眼心反射48次,采用χ2检验,P<0.01,两组间眼心反射发生率差异有统计学意义。两组间眼心反射等级差别采用秩和检验,P>0.05,在发生眼心反射患者中,两组间眼心反射等级分布差异无统计学意义。结论:应用7.5g/L罗哌卡因混合20g/L利多卡因作眼球筋膜囊下麻醉在斜视手术应用有一定的优越性,值得推广应用。AIM： To assess the clinical efficacy of sub -tenon anesthesia using a ropivacaine and lidocaine mixture for strabismus surgery. METHODS： Totally 80 patients with horizontal strabismus who underwent local anaesthesia surgery were randomly divided into test group and control group.All cases received either sub - tenon anesthesia or subconjunctival anesthesia with 7.5g/L ropivacaine and 20g/L lidocaine mixtures randomly. Intraoperative and postoperative pain scores and oculocardiac reflex were assessed. RESULTS： All 80 cases were successful completion of the surgery under local anesthesia.According to visual analogue scale （ VAS） , excellent 12 cases, good 21 cases, fair 6 cases, poor 1 case in test group and excellent 2 cases, good 25 cases, fair 12 cases, poor 1 case in control group.There was significant difference by rank sum test （P〈0.01 ）.The number of ocular rectus muscle and oculocardiac reflex condition during operation： muscular traction in test group was 74, oculocardiac reflex was 26;in control group it was 76 and 48 respectively. The incidence of oculocardiac reflex between the two groups was significant difference by χ2 test （P〈0.01）.Rank sum test were used in oculocardiac reflection grade of two groups, there was no statistically difference （P〉0.05）. CONCLUSION： Sub-tenon anesthesia using a 7.5g/L ropivacaine and 20g/L lidocaine mixture proves to be an efficient procedure for strabismus surgery, which is worth popularizing and applying.

关 键 词：斜视手术 局部麻醉 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]