自控镇静镇痛在斜视手术的应用

Application of patient-controlled sedation and analgesia during strabismus surgery

目的探讨患者自控镇静镇痛(PCSA)在斜视手术的应用。方法将68例斜视手术患者随机分为舒芬太尼联合异丙酚PCSA组(P组)和单纯局麻组(C组)。P组局麻辅以PCSA。术中观察收缩压、心率、镇静评分、患者合作度评分、满意度评分、疼痛评分及眼心反射、低氧血症等不良反应。结果与基础值比较,P组仅术中10min的收缩压升高、心率加快;C组术中各时点均显著升高。P组镇静评分、合作度和满意度评分显著高于C组,而疼痛评分、躁动、呻吟发生率显著低于C组。结论舒芬太尼联合异丙酚PCSA应用于斜视手术是安全有效的麻醉方式。

Objective To comparing the safety and effectiveness of patient-controlled sedation and analgesia with topical anesthesia during strabismus surgery. Methods Sixty-eight patients were selected and randomly divided into two groups （n=34）： patient-controlled sedation and analgesia （P group） and control group（C group）. SBP, HR, Ramsay＇s score, cooperation score, satisfactory score, visual pain score（ VAS ） and side-effects such as agitation and low SpO2 during the surgery were measured. Results There were no significant changes of SBP, HR in P group from 10 minutes after the starting of operation to the end,while SBP, HR in C group were higher in all the procedure than those of the base value. Ramsay＇s score, cooperation score, satisfactory score of the patients in P group were higher than those in C group. VAS score, agitation and groan incidence were higher in C group than those of in P group. Conclusions Patient-controlled sedation analgesia with a combination of sufentanil and propofol is a safe and effective method for strabismus surgery.