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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
ARTICLE HIGHLIGHTS
Research background
During cataract surgery anesthesia, the low pH of proparacaine can produce some stinging and complications such as corneal damage and poor wound healing that may arise from the use of additional drops intraoperative. Therefore, an alternative adjunct to anesthesia needs to be sought to improve anesthesia and reduce the amount of intraoperative proparacaine.
Research motivation
Search for a new anesthesia method for cataract surgery.
Research objectives
To investigate a more suitable anesthesia method for geriatric cataract phacoemulsification to provide better analgesia and improve clinical efficacy.
Research methods
130 geriatric cataract patients who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the study and divided into the proparacaine surface anesthesia group (SA group, 65 cases) and the compound acupuncture-medicine anesthesia group (CAMA group, 65 cases), among which, patients in CAMA group were given acupuncture analgesia on the basis of SA. The preoperative anxiety (SAS score, SAI score), intraoperative stress, vital signs, analgesia, and cooperation, as well as postoperative adverse events were compared between both groups.
Research results
The results showed that the anxiety of patients in CAMA group was more markedly relieved, and their Self-Rating Anxiety Scale score and state anxiety inventory score decreased more dramatically. During the operation, the secretion of E, NE, and Cor in CAMA group showed no marked change compared to the preoperative period, which was markedly lower than that in SA group, meanwhile, their heart rate, blood pressure, and respiratory rate were maintained more stable without significant fluctuations. In addition, the incidence of intraoperative pain and the number of additional anesthesia in CAMA group were markedly lower than those in SA group, and they could effectively avoid eye movements and eyelid squeezing movements to better cooperate with the surgeon in completing the surgery. Furthermore, CAMA could markedly reduce intraoperative adverse effects and had better safety.
Research conclusions
Proparacaine SA combined with acupuncture analgesia can provide better analgesia with guaranteed safety.
Research perspectives
Traditional medical acupuncture anaesthesia for cataract surgery provides good sedation and analgesia, which effectively enhances the anaesthetic effect of proparacaine and reduces adverse effects, thus showing great potential in geriatric cataract phacoemulsification.
