中国临床药学杂志

目的 探究上海和江苏医疗机构眼科表面麻醉药的使用现状及存在问题，为表面麻醉药的规范化使用与管理提供依据。方法 采用便利抽样法，通过问卷星对上海和江苏31家医疗机构的管理者和142名眼科表面麻醉操作人员进行问卷调查，从表面麻醉药应用场景、管理制度、用药方案及质量控制等方面展开分析。结果 38.71%(12/31)的医院尚未建立标准操作规程（SOP），不同SOP制定情况下临床护士执行行为差异有统计学意义（P<0.01）。各医院操作人员在用药方案上存在差异：常用药物种类为0.4%盐酸奥布卡因滴眼液（0.5 mL/2 mg），给药方案则依据操作类型调整，手术首次给药多在术前5 min内；有创治疗和手术以间隔5min、分3次给药为主；无创治疗和检查则以单次给药为主。质量控制方面，15.67%(21/134)的操作人员重复使用一次性表面麻醉药，非一次性表面麻醉药在使用过程中存在开启时间未标注及使用期限未严格核查等不足；在用药观察环节，23.24%(33/142)的操作人员未严格执行用药观察，45.77%(65/142)的操作人员曾观察到表面麻醉药的不良反应。结论 眼科表面麻醉药的管理存在操作规程缺乏、用药方案欠统一、质量控制措施执行有待完善等不足。医疗机构应重视标准化管理体系建设，加强专业培训，优化个体化用药方案，促进眼科表面麻醉药的规范使用。

AIM To investigate the current usage status and existing problems of ophthalmic surface anesthetics in medical institutions across Shanghai and Jiangsu, providing a reference for standardized use and management. METHODS A convenience sampling method was employed to conduct a questionnaire survey through Questionnaire Star, targeting 31 medical institutions in Shanghai and Jiangsu, including 31 managers and 142 ophthalmic surface anesthetic operators. Subsequently, statistical analysis was conducted on the evaluation of application scenarios, management system, medication regimen and quality control procedure for the use of ophthalmic surface anesthetics. RESULTS About 38.71%(12/31) of hospitals had not yet established a standard operating procedure(SOP). The differences in clinical nurses' implementation behaviors under different SOP formulation conditions were statistically significant(P < 0.01). Variations in dosage regimens existed among operators across hospitals. The commonly used medication was 0.4% oxybuprocaine hydrochloride eye drops(0.5 mL/2 mg), with dosing regimens adjusted according to procedure type. For surgical procedures, initial administration typically occurred within 5 minutes preoperatively. Invasive treatments and surgeries predominantly employed a three-dose regimen administered at 5-minute intervals, while non-invasive treatments and examinations primarily utilized single-dose administration. Regarding medication management, 15.67%(21/134) of operators reused single-dose surface anesthetics, deficiencies were observed in the labeling of opening times and verification of expiration dates for multi-dose surface anesthetics during clinical use; in the medication observation phase, 23.24%(33/142) of operators did not strictly implement medication observation, and 45.77%(65/142) had encountered adverse reactions. CONCLUSION Deficiencies exist in the management of ophthalmic surface anesthetics, including a lack of operational protocols, inconsistent dosage regimens, and inadequate implementation of quality control measures. Medical institutions should emphasize building standardized management systems, strengthening professional training, optimizing individualized dosage regimens, and promoting the standardized use of ophthalmic surface anesthetics.