儿童全麻术中高眼压的预防

The prevention of high intraocular tension in the operation of general anesthesia for children

目的探讨儿童全麻术中高眼压的预防。方法观察43例儿童白内障摘出术,随机分为两组。观察组23例,应用氯胺酮麻醉联合利多卡因球后麻醉;对照组20例只应用氯胺酮麻醉。观察麻醉达成5min后的术眼眼压及术中有无后囊前突、虹膜膨出等高眼压征象。结果观察组麻醉达成5min后术眼平均眼压(17.34±4.26)mmHg,后囊前突3例、虹膜膨出1例;对照组术眼平均眼压(21.23±4.35)mmHg,后囊前突9例、虹膜膨出3例。结论氯胺酮可使眼外肌张力增加,眼压升高;球后麻醉可使眼外肌松弛,眼压降低,从而减少氯胺酮用量,使麻醉更加安全可靠。

Objective Discussd the preventive methods of high mtraocular tension in the operation of general anesthesia for children. Methods 43 children patients who got cataract surgery were observed. We divided them into two different groups random- ly. There were 23 patients in observing group, katamine hydrochloride mainline jointed with lidocaine retrobulbar mlesthesia. The other comparison group had 20 cases, which were only injected by katamine hydrochloride. Observed whether the IOP was stable and whether patients had high IOP syndromes, like burse extruding, iris bulge and so on. Results Average intraocular pressure of the observation group was 17.34 ±4.26 mmHg,3 cases had bursa extruding,and 1 patient had iris bulge; file average intraocular pressure of the comparison group was 21.23±4.35 mmHg, 9 cases had bursa extruding, and 3 patients have got the syndrome of iris bulge. Conclusion Katamine hydrochloride can valse intraocular pressure, so it is thought that the extraoctfiar muscle tension is the main reason, the retrobnlbar anesthesia can make the extraocular muscle anesthesia, relax, thus reduce anesthesia intraocular pressure. In addition, the general anesthesia and retrobulbar anesthesia can reduce the dosage of katamine hydrochloride, which make anesthesia much safer and more reliable.