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