摘要
目的探讨喉罩静吸全身麻醉联合丙美卡因表面麻醉在小儿斜视手术中的应用价值。方法抽取南阳市眼科医院2018年11月至2020年11月收治的小儿斜视手术患儿80例,按随机数字表法分为观察组(40例)与对照组(40例)。对照组采用气管插管静吸全身麻醉,观察组采用喉罩静吸全身麻醉联合丙美卡因表面麻醉。比较两组术中眼心反射发生率,术后1、2、6 h Bier改良面部表情评分,麻醉前(T1)、手术开始时(T2)及拔管后20 min(T3)平均动脉压、心率、苏醒时间、苏醒时烦躁发生率及不良反应发生率。结果观察组术中眼心反射发生率(20.00%,8/40)低于对照组(45.00%,18/40),P<0.05。术后1、2、3 h,观察组Bier改良面部表情评分均低于对照组(P均<0.05);T2、T3时,观察组平均动脉压、心率低于对照组(P<0.05);观察组苏醒时间短于对照组,苏醒时烦躁发生率低于对照组(P<0.05)。观察组不良反应发生率(5.00%,4/40)与对照组(7.50%,5/40)比较差异未见统计学意义(P>0.05)。结论喉罩静吸全身麻醉联合丙美卡因表面麻醉应用在小儿斜视手术,可降低术中眼心反射发生率,缓解疼痛,对血流动力学影响小,可缩短苏醒时间,降低苏醒时烦躁发生率,存在麻醉安全性。
Objective To investigate the application value of laryngeal mask aspiration general anesthesia combined with promecaine epimanaesthesia in pediatric strabismus operation.Methods Eighty children who underwent strabismus surgery in Nanyang Eye Hospital from November 2018 to November 2020 were selected,and they were divided into observation group(40 cases)and control group(40 cases)according to random number table method.The control group was given endotracheal intubation general anesthesia,while the observation group received laryngeal mask inhalation general anesthesia combined with promecaine epimanaesthesia.The incidence of intraoperative ophthalmocardiac reflex,Bier modified facial expression score 1 hour,2 hours and 6 hours after surgery,mean arterial pressure before anesthesia(T1),at the beginning of surgery(T2)and 20 minutes after extubation(T3),heart rate,time to recovery,incidence of emergence agiation and incidence of adverse reactions were compared between the two groups.Results The incidence of oculocardiac reflex(20.00%,8/40)in the observation group was lower than that in the control group(45.00%,18/40),P<0.05.The Bier improved facial expression score of the observation group was lower than that of the control group 1 hour,2 hours and 3 hours after surgery(all P<0.05).At T2 and T3,the mean arterial pressure and heart rate of the observation group were lower than those of the control group(P<0.05).The waking time of the observation group was shorter than that of the control group,and the incidence of emergence agitation was lower than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(5.00%,4/40)and the control group(7.50%,5/40),P>0.05.Conclusions Laryngeal mask inhalation general anesthesia combined with promecaine epimanaesthesia in pediatric strabismus surgery can reduce the incidence of intraoperative occulocardiac reflex and relieve pain,with little effect on hemodynamics;morover,it can shorten the recovery time,reduce the incidence of emergence agitation,and have the safety.
作者
苏云锋
杨潞培
惠永跃
Su Yunfeng;Yang Lupei;Hui Yongyue(Department of Anesthesiology,Nanyang Eye Hospital,Nanyang 473000,China)
出处
《中国实用医刊》
2023年第7期61-64,共4页
Chinese Journal of Practical Medicine
关键词
斜视
小儿
喉罩
全身麻醉
丙美卡因
表面麻醉
Strabismus
Children
Throat mask
General anesthesia
Promethacaine
Tropical anesthesia
