眼球筋膜囊下麻醉在斜视手术中眼心反射观察

Clinical observation of the effects of sub-tendon anesthesia on oculocardiac reflex during strabismus surgery

目的观察眼球筋膜囊下麻醉对局部麻醉下斜视手术中的眼心反射(OCR)影响。方法选择80例局部麻醉手术的水平性斜视患者,分成实验组和对照组各40例,用0.75%罗哌卡因混合2%利多卡因分别作眼球筋膜囊下麻醉和结膜下浸润麻醉,并记录扣取肌肉时OCR的发生情况。结果 80例患者均能在局部麻醉下顺利完成手术,实验组牵拉内直肌36条,发生OCR 16次,牵拉外直肌38条,发生OCR 10次;对照组牵拉内直肌38条,发生OCR 26次,牵拉外直肌38条,发生OCR 22次,两组间牵拉肌肉引起的OCR发生率差异有显著统计学意义(实验组35%,对照组63%,P<0.05),而两组间OCR等级差异无显著统计学意义(P>0.05)。结论眼球筋膜囊下麻醉在局麻斜视手术中具有较低OCR发生率,是一种安全有效的斜视手术麻醉方法,值得推广应用。

Objective To observe the effects of sub-tenon anesthesia on oculocardiac reflex during strabismus sur- 8ery. Methods A prospective, case-control study was pedormed on 80 patients underwent horizontal strabismus corrective surgeries. Subjects randomly received either sub-tendon anesthesia or subconjunctival anesthesia with 0.75% ropivacaine and 2% lidecaine mixtures. Intranpermive eculocaniiac reflex were evaluated. Results Surgeries were successfully com- pleted in all 80 patients. The incidence of eculocardiac reflex was significantly lower in sub-tendon anesthesia group than in subconjunctlval anesthesia group （35% vs. 63%, P 〈0.01 ）. The grades of eculecardlac reflex were not different between the two groups （ P 〈0.01 ）. Condusion Sub-tenon anesthesia proves to be a safe and reliable procedure for strabismus surgery.