对角膜擦伤的局部眼科麻醉剂
Michael Sulewski1, Louis Leslie2, Su-Hsun Liu2,3
1Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
The Cochrane database of systematic reviews
|August 9, 2023
概括
局部眼科麻醉剂对角膜擦伤的疼痛缓解提供了很少的确定性. 证据显示,它们对愈合的效果很小,并没有减少并发症,因此质疑它们对磨损后眼睛疼痛的有效性.
科学领域:
- 眼科医生 眼科 眼科
- 药理学 药理学是指药理学的学科.
背景情况:
- 局部眼科麻醉剂 (胺基和) 用于缓解疼痛,但引起了对滥用和并发症的担忧.
- 角膜擦伤,无论是创伤还是手术,都可能导致明显的眼睛疼痛.
- 评估这些麻醉剂的疗效和安全性对于患者护理至关重要.
研究的目的:
- 评估局部眼科麻醉剂与安慰剂或角膜擦伤其他治疗方法相比的有效性.
- 评估安全性和与使用相关的潜在并发症.
主要方法:
- 通过全面的数据库搜索确定的随机对照试验 (RCT) 的系统审查 (Cochrane CENTRAL,MEDLINE,Embase.com,LILACS,ClinicalTrials.gov,WHO ICTRP).
- 包括的试验涉及所有年龄段的参与者,在呈现后48小时内出现角膜擦伤.
- 分析了疼痛控制,上皮愈合和眼部并发症的数据,评估了偏差风险和证据的确定性.
主要成果:
- 局部麻醉剂在24小时后对手术后疼痛有适度的减轻,而安慰剂则没有,但在创伤后的病例中几乎没有效果.
- 在48-72小时内减少疼痛的证据是有限的,对手术后的疼痛几乎没有影响.
- 与安慰剂或NSAID相比,没有发现对上皮质愈合或减少眼部并发症的实质性影响.
结论:
- 目前的证据对局部麻醉剂在减少角膜擦伤引起的眼睛疼痛的疗效提供了很低的确定性.
- 现有的数据不支持推局部麻醉剂来缓解角膜擦伤的疼痛.
- 需要进一步的研究来澄清这些药物的作用和安全性,以控制角膜磨损.
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