目的：探讨超声乳化术中透明质酸酶对筋膜下麻醉的疗效。方法：该研究是一项双盲随机临床试验,在Nikookari眼科医院进行了长达5mo。行超声乳化术的候选患者中接受筋膜下麻醉的42眼随机分为均等的两组,分别应用20g/L的利多卡因溶液2mL+150U/mL透明质酸酶（LH）,和单纯20g/L的利多卡因溶液2mL（L）。筋膜下注射15min后活动受抑制。患者和医生都非常满意,对于术后疼痛的抑制（视觉模拟评分,the visual analogue scale, VAS）也同样满意。统计学分析采用列联表（包括卡方检验或Fisher's精确检验）和参数分析（独立样本t检验）。结果：活动抑制(33.3% vs4.8%, P=0.04)、患者满意度(85.7% vs57.1%, P=0.04)和医生满意度(87.5% vs52.4%, P=0.02),LH组明显高于L组。VAS在相同组内明显较低(1.90±1.45 vs3.00±1.55, P=0.04)。结论：利多卡因溶液+透明质酸酶的筋膜下麻醉明显使得眼部活动受限,提高了患者和医生的满意度,并减轻了术后疼痛。

AIM: To investigate the effect of hyaluronidase use on the quality of sub-Tenon's anesthesia for phacoemulsification.METHODS: This was a randomized, double-blind clinical trial which was conducted at Nikookari Eye Hospital for 5 months. Forty-two eyes of candidates for phacoemulsification under sub-Tenon's anesthesia were randomly allocated to two equal groups and received either 2mL of lidocaine 2% solution with (LH), or without (L) addition of hyaluronidase (150U/mL). Akinesia was assessed 15 minutes after sub-Tenon's injection. Patients and surgeon's satisfaction, as well as the postoperative pain (the visual analogue scale, VAS) were investigated after operation. The contingency tables (including the Chi-square or Fisher's exact tests, when appropriate) and parametric analysis (the independent samples ttest) were used for statistical analysis.RESULTS: Complete akinesia (33.3% vs4.8%, P=0.04), as well as the patients (85.7% vs57.1%, P=0.04) and surgeon's satisfaction (87.5% vs52.4%, P=0.02) were significantly more frequent in LH than in L group. The mean VAS was significantly lower in the same group (1.90±1.45 vs3.00±1.55, P=0.04).CONCLUSION: Addition of hyaluronidase to lidocaine solution for sub-Tenon's anesthesia significantly improves the ocular akinesia, enhances the intra-operative patients and surgeons' satisfaction, and attenuates the postoperative pain.