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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Clinical study of acupuncture combined with surface anesthesia using proparacaine in geriatric cataract phacoemulsification
Ping Dong, Li-Fang Wang, Li-Xiang Zhang, Fang Li, Hui-Su Yin, Zhi-Xia Dou, Xiu-Ju Huang, Rui Xu, Wu-Lin Zhang
Ping Dong, Department of Acupuncture and Rehabilitation, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
Li-Fang Wang, Fang Li, Xiu-Ju Huang, Rui Xu, Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
Li-Xiang Zhang, Department of Pediatrics, Hebei General Hospital For Veterans, Xingtai 054000, Hebei Province, China
Hui-Su Yin, Department of Science and Education, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
Zhi-Xia Dou, Department of Ocular Trauma, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
Wu-Lin Zhang, Department of Cataract, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
Author contributions: Dong P conceived the overall research goal and designed the research plan and model design; Dong P, Wang LF, Zhang LX and Zhang WL conducted the feasibility analysis and reviewed and supervised the study; Dong P, Li F, Dou ZX, Huang XJ and Yin HS collected clinical data; Xu R and Zhang WL conducted statistical processing and data analysis; Dong P and Zhang WL are responsible for writing the first draft of the paper; Dong P is responsible for the review, revision, and quality control of the paper; all authors reviewed and approved the final draft of the paper.
Supported by 2019 Hebei Provincial Medical Science Research Project Plan, No. 20191053.
Institutional review board statement: The study was approved by Ethics Committee of Hebei Eye Hospital.
Informed consent statement: All study participants, or their family members, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors report no relevant conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Wu-Lin Zhang, Doctor, Chief Physician, Department of Cataract, Hebei Eye Hospital, No. 399 Quanbei East Street, Xingtai 054001, Hebei Province, China. eyewlzhang@vip.sina.com
Received: May 31, 2023
Peer-review started: May 31, 2023
First decision: June 14, 2023
Revised: June 28, 2023
Accepted: July 7, 2023
Article in press: July 7, 2023
Published online: July 26, 2023
BACKGROUND
During anesthesia administration for cataract surgery, low pH of proparacaine may induce pain or complications such as corneal damage and poor wound healing, with the use of additional drops intraoperatively increasing the risk of complications. Accordingly, there is a clinical need for adjuncts to local anesthesia needs to improve the efficiency of anesthesia and reduce the required amount of intraoperative proparacaine.
AIM
To identify a method of anesthesia for geriatric cataract phacoemulsification that provides more efficient analgesia and improves clinical efficacy.
METHODS
A total of 130 geriatric patients with cataracts who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the present study. Patients were divided into the proparacaine surface anesthesia (SA) group (65 cases) and the compound acupuncture-medicine anesthesia group (CAMA group, 65 cases). Patients in the CAMA group were provided acupuncture analgesia in addition to SA. Preoperative anxiety [Self-Rating Anxiety Scale (SAS) score and state anxiety inventory (SAI) score], intraoperative stress, vital signs, analgesia, and cooperation, as well as postoperative adverse events, were compared between groups.
RESULTS
More marked reductions in anxiety were observed among patients in the CAMA group, with corresponding reductions in SAS and SAI scores. During the operation, no change in the secretion of E, NE, or Cor group compared to the preoperative period was observed in the CAMA, which was markedly lower than that in the SA group. Heart rate, blood pressure, and respiratory rate were more stable intraoperatively in the CAMA group. In addition, the incidence of intraoperative pain and the number of additional doses of anesthesia required in the CAMA group were markedly lower than in the SA group. Accordingly, patients in the CAMA group were able to avoid eye movements and eyelid closing leading to greater cooperation with surgeons during surgery. Furthermore, marked reductions in intraoperative adverse effects were observed in the CAMA group, indicating greater overall safety.
CONCLUSION
Proparacaine SA combined with acupuncture as an analgesic provides improved analgesia with greater safety compared to surface anesthesia with proparacaine during geriatric cataract phacoemulsification.
Core Tip: Innovatively use acupuncture anesthesia in traditional medicine to assist proparacaine in the anesthesia process of cataract surgery, to effectively improve the anesthetic effect, stabilize intraoperative vital signs, and reduce postoperative complications in geriatric cataract phacoemulsification.
