表面麻醉下白内障超声乳化手术中的镇痛效果

目的　客观评价表面麻醉下白内障超声乳化手术的止痛效果。方法　在铺巾前、开睑后滴“0 .4%爱尔卡因”表麻剂二次后做白内障超声乳化手术。随机选择角膜切口组、巩膜切口组各 12 0例 ,手术结束后根据病人主观疼痛感觉 ,按疼痛分类记录 ,分析镇痛效果。结果　本研究手术时间范围 5～ 2 5分钟 ,平均 7.2分钟。角膜切口组疼痛感觉 : 级 11只眼 (9.1%) , 级 12只眼 (10 %) , 级 7只眼 (5 .8%) , 6只眼 (5 .0 %) ;巩膜切口组疼痛感觉 : 级 5只眼 (4.2 %) , 级 9只眼 (7.5 %) , 级 8只眼 (6 .7%) , 级 4只眼 (3.3%)。两组间差异无显著性 (P >0 .0 5 ) ;手术并发症 :角膜切口组环行撕囊失败 8只眼 (6 .7%) ,后囊膜破裂 4只眼 (3.3%) ,巩膜切口组环行撕囊失败 6只眼 (5 .0 %) ,后囊膜破裂 5只眼 (4.2 %) ,无晶体核坠入玻璃体内和眼内大出血等严重并发症。结论　表面麻醉方式行超声乳化镇痛效果良好 ,手术安全、舒适。

The effect of analgesia in phacoemulsification under topical anesthesia

Objective To evaluate the effect of analgesia of phacoemulsification under topical anesthesia. Method We drop 0.4% Alcine twice before spread scarf and open eyelid respectively and Select 120 corneal incisions and 120 scleral incisions randomly. We asked patients about the feelings objectively.Result The average time of operation was 7.2 minutes, arranged from 5 to 25 minutes. In corneal incision, the pain from 1 grade to 4 grade were 11 eyes (9.1%), 12 eyes (10%), 7 eyes(5.8%) and 6 eyes (5.0%) respectively. In scleal incisions these were 5 eyes(5.4%), 9 eyes(7.45%), 8 eyes (6.7%), 4 eyes(3.3%) respectively. There were no significant statistic difference between these two groups(P>0.05). The postcapsule disruption was 4 eyes(3.3%) and the anterior capsule laceration was 8 eyes(5.8%). No unclear dropping into vitreous and interocular hematorrhea happened.Conclusion The phacoemulsification under topical anesthesia had good effect of analgesia and the method was safe and effective.