论著

丙泊酚 - 阿芬太尼 - 利多卡因混合剂用于成人白内障日间手术镇静

Application of propofol-alfentanil-lidocaine mixture for ambulatory adult cataract surgery under sedation

:864-869
 
目的:评价丙泊酚-阿芬太尼-利多卡因混合剂在成人白内障日间手术中的麻醉镇静效果与不良反应。方法:回顾性分析2021年1月至2021年6月中山大学中山眼科中心接受丙泊酚-阿芬太尼-利多卡因静脉镇静下白内障日间手术的患者(静脉镇静组,n=30),并匹配同一主刀医师、诊断相似且在丙美卡因表面麻醉下白内障手术患者(表麻组,n=30)。比较两组患者围手术期血流动力学变化、手术中眼位评级、手术中断的次数、手术时间、手术后苏醒时间、出院时间、术中手术体验以及术后不良事件等指标。结果:所有患者均在原麻醉方式下顺利完成手术;与表麻组相比,静脉镇静组手术中断次数显著降低(P<0.05),围手术期血压更平稳,且术后满意度评价明显升高(P<0.05)。结论:丙泊酚-阿芬太尼-利多卡因静脉镇静能显著提升白内障日间手术患者的就医体验,而不影响手术进程。
Objective: The aim of this study is to observe the efficacy and safety of propofol-alfentanil-lidocaine mixture in adult patients for cataract ambulatory surgery. Methods: Thirty adult patients undergoing cataract ambulatory surgery sedated by propofol-alfentanil-lidocaine mixture from January 2021 to June 2021 were enrolled in this retrospective study (sedation group, n=30). Meanwhile, another thirty patients with similar diagnosis performed by the same surgeons under topical anesthesia were matched in this study (topical anesthesia group, n=30). The scores of intraoperative eye position, the number of surgical interruptions due to poor cooperation, surgical time, emergence time, time to discharge, changes in blood pressure, surgical experience, as well as any adverse events were compared between the two groups. Results: The surgeries were successfully completed in all patients in both groups. Compared to topical anesthesia group, patients under sedation showed less surgical interruptions and more stable hemodynamics during the surgery, as well as better surgical experience (all P<0.05). Conclusion: Sedation with propofol-alfentanil-lidocaine mixture can significantly improve the surgical experience of patients undergoing cataract ambulatory surgery without prolonging duration of the surgery.
论著

喉罩复合七氟醚麻醉在小儿门诊全身麻醉眼底荧光素造影检查中的应用

Application of inhaled sevoflurane via laryngeal mask airway in children undergoing outpatient fundus fluorescein angiography with general anesthesia

:695-699
 
目的:观察喉罩通气吸入七氟醚麻醉在小儿眼底荧光素造影检查(fundus fluorescein angiography,FFA)期间眼位情况、眼球运动的发生率和丙泊酚调整眼位的有效率。方法:回顾性分析2018年6月至2019年12月七氟醚麻醉下接受FFA的儿童的病例资料,记录检查开始时眼位分级、检查中眼球运动发生率、丙泊酚调整眼位的有效率、麻醉后恢复自主活动时间以及不良事件。结果:纳入1~9岁患儿54例,检查开始时42.6%(23/54)的患者眼位1级,51.9%(28/54)的患者眼位2级,5.6%(3/54)的患者眼位3级,检查中眼球运动发生率为61.1%(33/54)。13%(7/54)的患儿需丙泊酚干预,丙泊酚1 mg/kg纠正眼位的有效率为100%。患儿麻醉后恢复正常活动的平均时间为24.4 min,未发生不良事件。结论:喉罩复合七氟醚的麻醉可为门诊小儿眼底荧光造影提供相对满意的麻醉质量,患者在麻醉后可迅速恢复日常活动,丙泊酚可迅速纠正检查中眼位不正。
Objective: To observe the eye position, the incidence of eye movement and the efficacy of propofol on correcting eccentric eyeball position in children undergoing examination of outpatient fundus fluorescein angiography (FFA) with inhaled sevoflurane via laryngeal mask airway. Methods: Children undergoing FFA with sevoflurane anesthesia from June 2018 to December 2019 were retrospectively reviewed. Eye position at the beginning of examination, incidence of eye movement during examination, the efficiency of propofol on correcting eccentric eyeball position during procedure, the time to resume normal activities, and adverse events were recorded. Results: Fifty-four children aged 1–9 years were included in this study. The rates of eye position from grade one to grade three at the beginning of examination were 42.6% (23/54), 51.9% (28/54), and 5.6% (3/54), respectively. The incidence of eye movement during examination was 61.1% (33/54). 13% (7/54) of children with unsatisfactory eye-position needed intervention with propofol. The efficacy of propofol (1 mg/kg) in correcting eye position was 100%. The mean time to return normal activities was 24.4 min. There were no any adverse events during the peri-anesthetic period. Conclusion: Inhaled sevoflurane via LMA can provide appropriate anesthesia for outpatient FFA in children. Children can resume daily activities soon after anesthesia. Propofol can return the incorrect eye position during examination
专家述评

重视小儿眼科麻醉前评估

Attach importance to assessment before anesthesia of pediatric ophthalmic surgery

:691-694
 
小儿眼科麻醉的挑战是既要保障患儿的麻醉安全又要提高手术接台效率。麻醉前的充分评估和详细的准备可以有效地降低麻醉期间的并发症。在麻醉前访视期间,需要做到仔细地询问病史,全面的麻醉体格检查及必要的实验室检查或专科会诊,完成充分告知任务,从而提高小儿眼科麻醉安全性。
The challenge of pediatric ophthalmic anesthesia is how to balance the safety and efficiency of ophthalmic surgery. Careful pre-operative evaluation and preparation can effectively reduce potential complications during pediatric ophthalmic anesthesia. During the preoperative assessment, it’s necessary to gather information, perform a full physical examination, take required laboratory tests or consultations with specialties, and deliver appropriate information and consent to increase the safety of pediatric ophthalmic anesthesia
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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