球周麻醉联合表面麻醉在全视网膜激光光凝术中的镇痛效果及安全性研究  

A Study on the Analgesic Effect and Safety of Peribulbar Anesthesia Combined with Topical Anesthesia in Panretinal Photocoagulation

作　　者：杨胜甫 YANG Sheng-fu(The People's hospital of Pizhou,Pizhou Jiangsu 221300,China)

机构地区：[1]邳州市人民医院眼科,江苏邳州221300

出　　处：《湖北科技学院学报(医学版)》2025年第1期53-56,共4页Journal of Hubei University of Science and Technology(Medical Sciences)

摘　　要：目的本研究旨在评估球周麻醉联合表面麻醉在全视网膜激光光凝术(PRP)治疗糖尿病视网膜病变(DR)中的镇痛效果及其对术后恢复的影响。方法研究共纳入64例DR患者,随机分为两组,单纯表面麻醉组(表面麻醉组)与球周麻醉联合表面麻醉组(球周麻醉组)。所有患者在PRP治疗前接受相应麻醉,治疗分4次完成。治疗后,评估并比较两组患者的治疗时长、术后疼痛程度(视觉模拟评分法,VAS)、疼痛持续时间、术后血压及心率变化,以及不良反应发生情况。结果与表面麻醉组相比,球周麻醉组治疗时长显著缩短(P<0.05);VAS评分显示球周麻醉组术后疼痛程度显著降低,且疼痛持续时间亦显著缩短(P均<0.05);球周麻醉组术后收缩压变化低(P<0.05),而舒张压及心率变化无显著差异(P>0.05)。两组间常见的不良反应(复视、皮下淤血、结膜水肿)并无明显差异(P>0.05),但是严重并发症(呕吐、头晕、心慌)球周麻醉组发生率比表面麻醉组低(P<0.05)。结论球周麻醉联合表面麻醉在PRP治疗DR中能显著缩短治疗时长、降低术后疼痛程度及持续时间,并减少术后不良反应,尤其是心慌症状,为DR患者提供了一种更为安全舒适的治疗选择。Objective To investigate the analgesic effect of peribulbar anesthesia combined with topical anesthesia in panretinal photocoagulation(PRP)for diabetic retinopathy(DR)and its impact on postoperative recovery.Methods 64 DR patients undergoing PRP treatment were included in this study,and randomly divided into the topical anesthesia surgery group(Topical anesthesia group)and the peribulbar anesthesia combined with topical anesthesia surgery group(Combined anesthesia group).The corresponding medication was administered before PRP treatment,and completed in four sessions.Post-treatment,the duration of treatment,postoperative pain level(Visual Analogue Scale,VAS),duration of pain,changes in blood pressure and heart rate,and the occurrence of complications were assessed for both groups.Results Compared to the topical anesthesia group,the duration of treatment and postoperative pain for the combined anesthesia group were shorter(P<0.05),the postoperative pain level,as measured by the VAS score,and systolic blood pressure were lower in the combined anesthesia group(P<0.05),while the changes of diastolic blood pressure and heart rate had no statistical difference between the two groups(P>0.05).There were no significant difference in common adverse reactions(diplopia,subcutaneous congestion,conjunctival edema)between the two groups(P>0.05),but the incidence of serious complications(vomiting,dizziness,palpitation)were lower in the peribulbar anesthesia group than those in the topical anesthesia group(P<0.05).Conclusion Peribulbar anesthesia combined with topical anesthesia in PRP treatment can effectively shorten treatment duration,reduce postoperative pain levels and duration,and decrease postoperative adverse reactions,especially palpitations,and finally providing a safer and more comfortable treatment option for DR patients.

关 键 词：糖尿病视网膜病变 全视网膜激光光凝术 球周麻醉 表面麻醉 术后恢复 

分 类 号：R587.2[医药卫生—内分泌]