不同麻醉方法对儿童斜视矫正术后躁动的影响

Effect of Anesthesia Methods on Postoperative Agitation in Children with Strabismus Operation

目的观察和评估三种不同麻醉方法应用于儿童斜视矫正术对术后躁动的影响。方法择期行斜视矫正术的儿童60例,年龄6～12岁,ASAⅠ级,随机分为三组,每组20例,气管插管组(T)、喉罩组(L)、面罩组(O)。三组患儿都由术者行眼球后神经阻滞及切口局部麻醉。记录手术时间、眼心反射、术中体动、苏醒时间、术后躁动及药物干预的例数,术后恶心、呕吐发生率,术中知晓例数。结果三组患儿手术时间无差异;O组有2例眼心反射;苏醒时间:L组<T组<O组(P<0.01),术后躁动的发生率:L组和O组10%,T组20%,药物干预的例数:L组和O组0例;T组2例;三组术后恶心呕吐发生率无差异;术中均无体动;术后随访均无术中知晓。结论 L组和O组术后躁动发生率低,清醒质量好,更适应于儿童斜视矫正术的麻醉,而L组更佳。

Objective To compare the effect of three anesthesia methods on the postoperative agitation in children with strabismus operation. Methods Sixty cases of 6 -12 years old and ASA I grade children with strabismus operation were randomly divided into three groups （ n = 20 ） ： group T （ tracheal intubation）, group L （ laryngeal mask airway, LMA ） and group O （ face mask）. All patients in the three groups underwent the retrobulbar block and incisions topical ane.sthesia. The operative time,intraoperative oculocardiac reflex, body movement, recovery time, cases with postoperative agitation and drug intervention,postoperative nausea,vomlting rate, cases of intraoperative awareness by postoperative follow-up. Results There was no difference in operation time among the three groups;2 cases in group O were with oculocardiac reflex. The awakening time：group L 〈 group T 〈 group 0 （P〈0.01）. The incidence of postoperative agitation was：10% in group L and 0,20% in group T. The number of cases with drug intervention ：0 cases in group L and O ;2 cases in group T. There was no difference in the incidence of postoperative emesis. There was no intraoperative body movement in all three groups. The postoperative follow-up showed no intraoperative awareness. Conclusion The rate of postoperative agitation is low and the quality of recovery from anesthesia is high in the patients with an- esthesia by LMA or face mask. Both methods, especially LMA, are suitable for the anesthesia of children with strabismus surgery.