眼科 ›› 2025, Vol. 34 ›› Issue (4): 285-288.doi: 10.13281/j.cnki.issn.1004-4469.2025.04.006

• 论著 • 上一篇    下一篇

利多卡因前房内麻醉在复杂性白内障超声乳化手术中的初步应用

蒋建伟   陈丹云   柳彬   黄鋆堂   

  1. 泉州市妇幼保健院儿童医院眼科,福建泉州362000
  • 收稿日期:2024-05-30 出版日期:2025-07-25 发布日期:2025-07-13
  • 通讯作者: 蒋建伟,Email:641566919@qq.com

Preliminary application of lidocaine anterior chamber anesthesia in complex cataract phacoemulsification surgery 

Jiang Jianwei, Chen Danyun, Liu Bin, Huang Yuntang   

  1. Department of Ophthalmology, Quanzhou Women′s and Children′s Hospital, Quanzhou Fujian 362000, China 
  • Received:2024-05-30 Online:2025-07-25 Published:2025-07-13
  • Contact: Jiang Jianwei, Email: 641566919@qq.com

摘要:  目的  探讨两种不同麻醉方式,在复杂性白内障超声乳化手术中运用的临床价值。设计  随机对照临床研究。研究对象  2022年5月至2023年9月泉州市妇幼保健院儿童医院日间病房复杂性白内障行超声乳化联合IOL植入手术患者82例(82眼)。方法  治疗组表面麻醉联合0.5%利多卡因前房内麻醉;对照组表面麻醉联合2%利多卡因球后麻醉。术中疼痛程度采用数字分级法(NRS)。主要指标  术中的疼痛感和手术耗时。结果  两组患者年龄、术前眼压、角膜内皮细胞数量、白内障类型构成基本情况均衡(P均>0.05)。对照组手术耗时(23.63±4.88)min,治疗组手术耗时(18.78±3.22)min(t=5.307,P=0.000)。对照组术中轻、中度疼痛7例,重度疼痛0例;治疗组轻、中疼痛5例,重度疼痛0例(χ2=0.502,P=0.778)。术后1个月角膜内皮较术前减少量对照组为(229.27±65.00)个/mm2,治疗组为(243.20±41.19)个/mm2(t=1.159,P=0.250)。结论  两种不同麻醉方式的麻醉效果差异无统计学意义;但前房注射眼内麻醉具有麻醉起效快、操作简单省时、并发症少等优点,是复杂性白内障手术较为理想的麻醉方式。

关键词:  , 复杂性白内障;眼内麻醉

Abstract:  Objective  To investigate the clinical value of two different anesthesia methods in complicated cataract phacoemulsification surgery. Design Randomized controlled clinical study. Participants 82 patients (82 eyes) underwent phacoemulsification combined with IOL implantation surgery for day-care unit complex cataracts at the Quanzhou Women′s and Children′s Hospital from May 2022 to September 2023. Methods In the treatment group, surface anesthesia combined with 0.5% lidocaine for anterior chamber anesthesia was performed. In the control group, surface anesthesia combined with 2% lidocaine postglobular anesthesia was performed. The degree of intraoperative pain is graded using the Numerical Rating Scale (NRS). Main Outcome Measures Intraoperative pain and phacoemulsification operation time. Results The age, preoperative intraocular pressure, number of corneal endothelial cells, and composition of cataract types were balanced between the two groups of patients (all P>0.05). The control group had a surgical time of (23.63±4.88) minutes, while the treatment group had a surgical time of (18.78±3.22) minutes (t=5.307, P=0.000). In the control group, there were 7 cases of mild to moderate pain during surgery, and 0 case of severe pain; There were 5 cases of mild to moderate pain and 0 case of severe pain in the treatment group (χ2=0.502, P=0.778). One month after surgery, the decrease in corneal endothelium compared to preoperative levels was (229.27±65.00) cells/mm2 in the control group and (243.20±41.19) cells/mm2 in the treatment group (t=1.159, P=0.250). Conclusions The difference between the two different anesthesia methods is not significant. The lidocaine anterior chamber anesthesia has the advantages of quick effect, less operation and fewer complications. It is an ideal anesthesia method for complicated cataract surgery.

Key words: Complicated cataract, Intraocular anesthesia