静脉麻醉药联合诱导对喉罩通气全身麻醉小儿外眼手术期间眼内压的影响因素探索  

To explore the risk factors for the effect of intravenous anesthetics combined with induction on intraocular pressure during pediatric external eye surgery under general anesthesia with laryngeal mask ventilation

作　　者：刘雁 徐钊 孙瑞强[2] 谢克亮[3] 刘爱华 Liu Yan;Xu Zhao;Sun Ruiqiang;Xie Keliang;Liu Aihua(Tianjin Key Laboratory of Retinal Functions and Diseases,Tianjin Branch of National Clinical Research Center for Ocular Disease,Eye Insti-tute and School of Optometry,Tianjin Medical University Eye Hospital,Tianjin 300384,China;Department of Anesthesiology,Tianjin Eye Hospital,Tianjin 300020,China;Department of Intensive Care Unit,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学眼科医院眼视光学院眼科研究所,国家眼耳鼻喉疾病临床医学研究中心天津市分中心,天津市视网膜功能与疾病重点实验室,天津300384 [2]天津市眼科医院麻醉科,天津300020 [3]天津医科大学总医院重症医学科,天津300052

出　　处：《国际麻醉学与复苏杂志》2023年第7期706-709,共4页International Journal of Anesthesiology and Resuscitation

基　　金：新疆维吾尔自治区自然科学基金面上项目(2020D01A06)。

摘　　要：目的探究常用静脉药物联合诱导喉罩通气全麻对小儿外眼手术期间眼内压(intraocular pressure,IOP)的影响,并对静脉麻醉诱导期前后影响IOP的因素进行探讨。方法选择2021年12月至2022年3月无青光眼病史的择期外眼手术患儿69例,年龄2~14岁,静脉给予丙泊酚、舒芬太尼、咪达唑仑、罗库溴铵进行麻醉诱导,喉罩通气全麻。记录患儿术眼诱导前后IOP,非术眼诱导前后及拔除喉罩后IOP;探讨体重、性别、年龄、身高、诱导药物剂量等对诱导前后IOP的影响。结果术眼诱导后IOP较诱导前降低(P<0.05);非术眼诱导后和拔除喉罩后IOP均较诱导前降低(P<0.05),诱导后IOP与拔除喉罩后IOP比较差异无统计学意义(P>0.05)。患儿性别、年龄、身高、体重、诱导药物剂量对术眼和非术眼诱导前后IOP影响均无统计学意义(P>0.05)。结论丙泊酚、舒芬太尼、咪达唑仑、罗库溴铵静脉诱导联合喉罩通气全麻在外眼手术中降低患儿IOP。Objective To investigate the effect of general anesthesia using intravenous drug sequential induction combined with laryngeal mask airway on intraocular pressure(IOP)during pediatric external eye surgery,and to explore the influencing factors on IOP before and after the intravenous anesthesia induction period.Methods A total of 69 children aged 2−14 years without history of glaucoma were selected from December 2021 to March 2022.They were anesthetized by intravenous administration of propofol,sufent⁃anil,midazolam,rocuronium bromide,and laryngeal mask ventilation under general anesthesia.The intraocular pressure before and after intraoperative eyes induction,before and after non⁃intraoperative eyes induction and before extubation were recorded.To investigate the effects of weight,sex,age,height,and dosage of induction drugs on IOP before and after induction.Results The IOP of the operated and non⁃operated eyes after induction was lower than that before induction,and the difference was statistically significant(P<0.05).There was a significant difference in IOP between non⁃operative eyes before induction and after extubation(P<0.05).The IOP difference between the non⁃operative eyes after induction and after extubation had little change,also,there was no statistical difference(P>0.05).Gender,age,height,weight,induction drug dosage,and other factors had no significant difference on the IOP difference between the op⁃erated and non⁃operated eyes before and after induction(P>0.05).Conclusions General anesthesia by intravenous induction of pro⁃pofol,sufentanil,midazolam,and rocuronium bromide combined with laryngeal mask ventilation reduces IOP in children undergoing ex⁃ternal surgery.

关 键 词：麻醉 全身 眼内压 儿童 外眼手术 喉罩通气 

分 类 号：R726.1[医药卫生—儿科]