頁籤選單縮合
題 名 | Sub-Tenon Anesthesia for Segmental Scleral Buckling and Assessment of Postoperative Pain=利用眼球Sub-Tenon注射麻醉行斷鞏膜外扣環術及術後疼痛痛程之評估 |
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作 者 | 莊蘭馨; 吳為吉; 楊克仁; 曹友平; 陳墩祿; 賴旗俊; | 書刊名 | 長庚醫學 |
卷 期 | 25:1 2002.01[民91.01] |
頁 次 | 頁16-22 |
分類號 | 416.746 |
關鍵詞 | 眼球Sub-tenon注射麻醉; 鞏膜外扣環術; 視覺類比計分表; Sub-tenon anesthesia; Scleral buckling; Visual analogue scale; |
語 文 | 英文(English) |
中文摘要 | 背景:評估利用眼球Sub-Tenon來實行片斷鞏膜外扣環術的安全性及可行性。 方法:我們一共收集了32個裂孔性視網膜剝離的病人,施以片段弧形鞏膜外扣環術(segmental scleral buckling)。每位病人皆給予眼球Sub-Tenon注射麻醉後手術,在點上局部麻醉劑之後,用剪刀在離輪布4mm的結膜上剪開一小洞,並使用鈍針頭由此灌注4ml的麻醉劑,隨即進行鞏膜外扣環術。在術中,斟酌病患疼痛的情形,再決定是否給予額外的Sub-Tenon灌注。我們並利用視覺類比記分表(VAS)來評估病人術中及術後的疼痛,並評估麻醉後病人眼球的轉動程度。 結果:在本研究中,並沒產生與麻醉相關的併發症。22位病人(69%)只需術前一次注射,即可完成麻醉。其餘10位病人,有9位(28%)則需額外的Sub-Tenon灌注才能完成手術,另外一位(3%)病人則需要再次的球後注射麻醉術才能完成手術。手術過程平順,並無嚴重的併發症。術後疼痛在6小時達到高峰。 麻醉5分鐘後,有5位病人(16%)的眼球可以完全轉動,全部只有4位(13%)的眼球完全不會轉動。在手術結束之後,則有16位病人(50%)眼球完全不會轉動,還有2位病人(6%)的眼球完全可以轉動。 結論:眼球Sub-Tenon灌注麻醉可被安全而有效地應用在視網膜剝離手術中的片段弧形鞏膜外扣環術,尤其使用在高度近視的病人,它可以避免使用球週或球後注射麻醉的併發症。 |
英文摘要 | Background: To evaluate the safety and efficacy of sub-Tenon anesthesia for segmental scleral buckling. Methods: Thirty-two patients diagnosed with rhegmatogenous retinal detachment were treated with segmental scleral buckling under sub-Tenon anesthesia. After topical anesthesia, a buttonhole was made through the conjunctiva and Tenon's capsule 4 mm posterior to the limbus. Four millilitersof anesthetic solution was then delivered into the posterior sub-Tenon space using a blunt cannula. The buckling procedure was done immediately after the completion of anesthesia. We evaluated akinesia and recorded the pain with a visual analogue scale after surgery. Results: There were no anethesia related complications. Twenty-two pateients (69%) reported no pain during surgery. Nine patients (28%) felt pain during surgery. However, the pain was tolerable and the surgeries were finished smoothly with or without a supplemental anesthetic solution. One patient (3%) experienced uncomfortable pain needed an additional retrobular block. Five patients (16%) retained complete eye movement 5 min after anesthesia, and only 4 patients (13%) experiencd total akinesia. At the end of the surgery, 16 patients (50%) had total akinesia and 2 patients (6%) retained complete eye movement. Conclusions: Sub-Tenon anesthesia is efficient and safe in segmental scleral buckling. It can prevent the complications of peribulbar or retrobulbar anesthesia and is a good alternative to both methods of anesthesia, especially in highly myopic eyes. |
本系統中英文摘要資訊取自各篇刊載內容。