RESUMO
Seventy-five patients with senile cataract underwent a planned extracapsular cataract extraction. They were randomly divided into two groups, receiving retrobulbar anesthesia (4 ml lidocaine 2% and 250 IU hyaluronidase) with or without adrenaline. Patients in the adrenaline group had the lowest mean intraocular pressure after the retrobulbar injection (p < 0.02) and they required a shorter time of digital bulbar massage to reduce tension before surgery (p < 0.01). They also appeared to have a deeper anterior chamber during the first part of surgery, although the difference was not statistically significant. The duration of postoperative analgesia was significantly prolonged in patients receiving adrenaline. Different mechanisms explaining the effects of adrenaline in retrobulbar anesthesia are discussed.
Assuntos
Anestesia Local/métodos , Extração de Catarata , Epinefrina/administração & dosagem , Hialuronoglucosaminidase/administração & dosagem , Lidocaína/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Câmara Anterior/efeitos dos fármacos , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Pressão Intraocular/efeitos dos fármacos , Lentes Intraoculares , Masculino , Pessoa de Meia-Idade , Órbita , Dor Pós-Operatória/tratamento farmacológico , Estudos Prospectivos , Pupila/efeitos dos fármacosRESUMO
Eighty patients with senile cataract were subjected to a planned extracapsular cataract extraction (ECCE) with implantation of a posterior chamber intraocular lens. Retrobulbar anesthesia was administered by injection of 4 mg lidocaine 2% with adrenalin. In 40 patients 150 I.U. hyaluronidase (Kinetin) was added to the anesthesia. The hyaluronidase group had a significantly lower frequency of iris prolapse, and deeper anterior chamber, both before and after expression of the lens nucleus. Possible mechanisms explaining the beneficial effect of hyaluronidase in extracapsular cataract surgery are discussed.