两种不同入路球后麻醉在微创玻璃体切割术中应用  

An analysis of the efficacy of two different retrobulbar anesthesia for micro-invasive vitrectomy

作　　者：刘文[1] 郑景伟[1] 华焱军[1] 李聪慧[1] 宋宗明[1] 

机构地区：[1]温州医学院附属眼视光医院,浙江省温州市325027

出　　处：《中国实用眼科杂志》2013年第8期1016-1020,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察比较两种不同人路球后麻醉在微创玻璃体切割手术的应用效果。方法临床病例对照研究，纳入行23G（23-gauge）联合25G经结膜无缝合玻璃体手术的患者120例并随机分为A、B两组，A组应用颞侧一针麻醉法，B组应用传统球后神经阻滞进行注射麻醉，从疼痛、制动、并发症、生命体征的变化、主刀及病人满意度等方面对两种方法进行比较研究。结果A、B两组间疼痛评分（F：319．1，P〈0．05）、制动评分（F=1267．9，P〈0．05），差异有统计学意义。麻醉过程中两组的疼痛评分存在差异（t=-6．4，p〈0．05），A组（3．3±1．9）〈B组（5．5±2．0）；制动评分在2min时A组（7．1±2．2）〈B组（9．1±2．O），（f=-5．2，P〈0．05）、4min时A组（3．8±2．O）〈B组（5．3±2．1），（t=-3．9，P〈0．05），差异有统计学意义。麻醉注射时血压A组（15．1±0．8）kPa〈B组（15．3±1．2）kPa，差异有统计学意义（t=--4．7，P〈0．05）；脉搏A组（109±7）次,／min〈B组（123±9）次/min，差异有统计学意义（t=-5．3，P〈0．05）。A组达制动要求时间短（t=-3．1，P〈0．05）。主刀（F=O．03，P〈0．05）和患者（F=0．01，P〈0．05）的满意度差异有统计学意义。A组口鼻麻木感2例，B组暂时性黑朦1例，10min后需要补充麻药：A组2例、B组7例，术中需补充麻药B组有6例；术中及术后均未发生麻醉相关的并发症。结论颞侧一针麻醉法用于微创玻璃体切割手术有良好效果，与传统球后麻醉相比，方法简单、注射次数少、主刀和患者满意度高，值得进一步研究。Objective To evaluate the efficacy of micro-invasive vitrectomy with two retrobulbar anesthetic methods. Methods Clinical case-control study, 120 patients scheduled for 3-port pars pla- na vitrectomy using 23-gauge instrumentation combined with 25-gauge infusion were randomly divid- ed into two groups according to anesthetic method. Patients in group A were anesthetized with an in- jection of narcotic through temporal side; patients in group B received the traditional retrobulbar nerve block. Main outcome measures included Visual analogue scale, immobilization score, complica- tions, vital signs observation, the surgeon and patient satisfaction etc. Results The differences of Vi- sual analogue scale （F =319.1, P 〈0.05） and immobilization score （F =1267.9, P 〈0.05） between group A and group B were statistically significant. Visual analogue scale of group A and group B was different during anaesthetizing （t =-6.4, P 〈0.05） and group A （3.3±1.9） 〈group B （5.5±2.0）. The differences of immobilization score at 2 minutes （t =-5.2, P 〈0.05） and 4 minutes （t =-3.9, P 〈 0.05） were statistically significant, and group A （7.1±2.2） 〈group B （9.1±2.0） at 2 minutes; group A （3.8±2.0） 〈group B （5.3±2.1） at 4 minutes respectively. The differences of blood pressure betweengroup A and group B were statistically significant （t =-4.7, P 〈0.05） with group A （15.1±0.8） 〈 group B （15.3±1.2）; respiratory rate in group A （109±7） was lower than that in group B （123±9） with statistical significance （t =-5.3, P 〈0.05）. The time of reaching immobilization criterion was shorter （t =-3.1, P 〈0.05） in group A. The differences of the satisfactory degree of surgeon （F = 0.03, P 〈0.05） and patient （F =0.01, P 〈0.05） between group A and group B were statistically sig- nificant. Oronasal numbness was found in 2 patients from group A, and temporary blackouts was found in 1 patient from group B. Two patients in group A and 7 patients in

关 键 词：球后麻醉 微创玻璃体切割术 视觉模拟评分 制动 

分 类 号：R779.6[医药卫生—眼科]