テノン嚢内麻酔に対する前房内麻酔の付加効果

Supplementary effect of intracameral to subtenon anesthesia

（R1-7AM−14）　他に合併症のない症例での白内障手術で，2％リドカイン1.5mlによるテノン嚢内麻酔を行い，これに前房内麻酔を追加した場合の効果と安全性を検討した。60眼を対象とした。30眼には水流核分離時にBSS Plus^®を前房に注入し，他の30眼には0.5％リドカイン1mlを注入した。術後に手術全体についての疼痛の程度を10段階として聴取した。後群では前群よりも有意に疼痛は低かった。術後の眼圧，矯正視力，角膜内皮細胞密度については，両群の間に差がなかった。手術1週後の前房フレア値は後群で有意に上昇していた。テノン嚢内麻酔で麻酔効果が不十分な症例には，前房囚麻酔を追加することが有用である。

A clinical evaluation was made on the efficacy and safety of intracameral anesthesia supplementing subtenon anesthesia during cataract surgery. Subtenon anesthesia was performed by injecting 1.5 ml of 2% lidocaine in 60 eyes. A group of 30 eyes received BSS Plus^® intracamerally during hydrodissection of the nucleus. The other 30 eyes underwent the same procedure added by 1.0 ml of 0.5% lidocaine. After surgery, the patients were asked about the intraoperative pain using a visual analogue scale graded into 10 stages. The intraoperative pain was significantly less in the group receiving supplementary intracameral anesthesia. There was no difference between the two groups regarding the postoperative intraocular pressure, corrected visual acuity or corneal endothelial cell density. The group receiving intracameral anesthesia showed higher values of aqueous flare at one week after surgery. The findings show the usefulness of supplementary intracameral anesthesia whenever subtenon anesthesia is insufficient.