학술논문
유리체절제안에서 백내장수술시 전방내주입마취의 유용성
Efficacy of intracameral Lidocaine During Phacoemulsification in Vitrectomized Eye
Efficacy of intracameral Lidocaine During Phacoemulsification in Vitrectomized Eye
Document Type
Article
Author
Source
대한안과학회지 / Journal of The Korean Ophthalmological Society. Nov 30, 2002 43(11):2136
Subject
Language
Korean
ISSN
0378-6471
Abstract
목적 : 우리체절제안에서 시행한 백내장수술시 마취방법으로 전방내주입마취의 안전성과 효과에 대해 알아보고자 하였다. 대상과 방법 : 2000년 10월부터 2001년 2월까지 부산백병원 안과에서 백내장수술을 시행받은 환자 중 이전의 유리체절제술 시행 환자 30명 30안과 시행되지 않았던 환자 30명 30안을 두군으로 나누고 60명 모두 전향적 이중맹검법으로 조사하였다. 모든 환자를 대상으로 술전 각막내피세포를 관찰하였으며 각각의 군을 다시 15안씩 나누어 군별로 1% lidocaine과 평형염액을 전방내 주입하여 환자의 통증을 시각적 아날로그 눈금을 이용하여 점수로 측정하였다. 또한 수술 후 1주일, 1개월, 3개월에 각막내피세포를 다시 촬영하여 형태학적 변화를 비교 분석하였다. 결과 : 술중 통증 점수는 유리체비절제술군의 경우 1% lidocaine 전방주입마취군과 대조군 사이에서는 유익한 차이가 없었으나, 유리체절제수술군에서는 1% lidocaine 전방주입마취군이 대조군보다 통계학적으로 유의하게 낮은 통증 점수를 보였다. 전방내주입마취로 인한 각막내피세포의 변화는 1% lidocaine 주입군과 대조군사이에 의미있는 차이는 없었다. 결론 : 유리체절제안에서 백내장수술시 보존제가 들어 있지 않은 1% lidocaine 전방재주입마취는 술중 환자의 통증을 조절하는데 유용하며, 또한 각막내피세포에도 영향이 없는 안전한 마취법으로 생각된다.
Purpose : This study was designed to evaluate the efficacy of intracameral lidocaine injection on patient`s pain relief during phacoemulsification in vitrectomized eyes the influence on the corneal endothelial cells. Methods : A prospective, double blind clinical trial was performed on 60 eyes of 60 patients who had undergone phacoemulsification from October 2000 to February 2001 at Busan PAIK Hospital. Thirty eyes had prior vitrectomy. Before surgery specular microscopic examination was performed. The patients were divided into vitrectomized and nonvitrectomized groups, and the lidocaine or placebo (BSS) was injected into the anterior chamber of 15 eyes each in two subgroups within each group. Pain was assessed using a visual analogue scale before, during and after operation. Endothelial cells were examinined at one week, one month, and three months after operation with a specular microscope. Results : In vitrectomized patients, intracameral lidocaine injection resulted in significantly lower intraoperative pain score. There were no significant differences in morphological changes of endothelium between lidocaine and placebo groups. Conclusions: Intracameral lidocaine injection with topical anesthesia had significant effect in intraoperative pain relief during phacoemulsification in vitrectomized eyes. There was no signigicant effects on corneal endothelium. We conclude that intracameral anesthesia is safe and reduces intraoperative pain in vitrectomized eyes.
Purpose : This study was designed to evaluate the efficacy of intracameral lidocaine injection on patient`s pain relief during phacoemulsification in vitrectomized eyes the influence on the corneal endothelial cells. Methods : A prospective, double blind clinical trial was performed on 60 eyes of 60 patients who had undergone phacoemulsification from October 2000 to February 2001 at Busan PAIK Hospital. Thirty eyes had prior vitrectomy. Before surgery specular microscopic examination was performed. The patients were divided into vitrectomized and nonvitrectomized groups, and the lidocaine or placebo (BSS) was injected into the anterior chamber of 15 eyes each in two subgroups within each group. Pain was assessed using a visual analogue scale before, during and after operation. Endothelial cells were examinined at one week, one month, and three months after operation with a specular microscope. Results : In vitrectomized patients, intracameral lidocaine injection resulted in significantly lower intraoperative pain score. There were no significant differences in morphological changes of endothelium between lidocaine and placebo groups. Conclusions: Intracameral lidocaine injection with topical anesthesia had significant effect in intraoperative pain relief during phacoemulsification in vitrectomized eyes. There was no signigicant effects on corneal endothelium. We conclude that intracameral anesthesia is safe and reduces intraoperative pain in vitrectomized eyes.