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Wydanie 1/2004

Porównanie odczuć bólowych przy znieczuleniu kroplowym i okołogałkowym w zabiegach fakoemulsyfikacji zaćmy

Comparison of topical vs peribulbar anesthesia in phacoemulsification

Edward Wylęgała, Antonina Jurewicz, Dorota Tarnawska, Dariusz Dobrowolski, Adam Jankowski, Jolanta Łogiewa-Toborek

Oddział Okulistyczny Szpitala Kolejowego w Katowicach Ordynator: dr n. med. Edward Wylęgała

Summary: Purpose: To compare the pain experienced by patients during the different stages of clear corneal phacoemulsification, performed under topical or peribulbar anesthesia. Methods: 523 patients aged from 28 to 89 (mean 57,5 year) who underwent clear corneal phacoemulsification were included in this study. All patients received oral sedation with midazolam 3,75 mg. They were divided in two groups: group I ? (262 patients) received topical anesthesia (proxymetocaine hydrochloride 1%) and group II ? (261 patients) received peribulbar anesthesia (2% lignocaine with 0,5% bupivacaine hydrochloride in 1: 1 proportion). Subjective pain was assessed at 6 intervals during surgery using a 6-point numerical scale. Results: In group I patients gave a pain score of 0 to 4 points (mean 2,25), and of 0 to 3 points in group II (mean 1,25). The patients experienced the most intense pain during phaco tip insertion into anterior chamber, and then during lens insertion. Conclusion: Topical anesthesia is an easy and well tolerated method and hence advisable for surgeons and cooperating anesthetists. The complicated cases of cataract surgery could be aided of 0,02% lignocaine intracameral anesthesia.

Keywords: topical anesthesia, peribulbar anesthesia, pain feeling, phacoemulsification.

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