多种麻醉联合在眼球摘除及眼胎植入术中的应用

The Application of Combined Anaesthesia on Ophthalmectomy and Orbital Hydroxyapatites Implantation

目的探讨球后麻醉、球周麻醉、结膜下浸润麻醉3种麻醉方式联合表面麻醉在眼球摘除及眼胎植入术中运用的效果。方法 106例眼球不能保留、需作眼内容物剜除(眼球摘除)及眼胎植入术的患者,随机分为A组和B组:A组53例采用球后麻醉、球周麻醉、结膜下浸润麻醉联合表面麻醉;B组53例采用单纯球后麻醉。结果1)A组53例平均麻醉起效时间为181.21s;B组53例平均麻醉起效时间为467.32s,两组间比较差异有统计学意义(P<0.05);2)A组术中和术后有8例出现疼痛症状,B组术中和术后有22例出现疼痛症状,两组间比较差异有统计学意义(P<0.05);3)A组平均镇痛持续时间200.68min;B组平均镇痛持续时间145.34min,两组间比较差异有统计学意义(P<0.05)。结论与单纯球后麻醉相比,球后麻醉、球周麻醉、结膜下浸润麻醉联合表面麻醉在眼球摘除及眼胎植入术中具有起效快、镇痛效果好、镇痛时间长的优点。

Objective To explore the combined application of retrobulbar anaesthesia,peribulbar anaesthesia, subconjunctival anaesthesia and topical anaesthesia in ophthalmectomy and orbital hydroxyapatites implantation. Methods One hundred and six cases required evisceration and orbital hydroxyapatites implantation for end-stage eye diseases were randomly divided into two groups,each group had 53 cases. Group A adopted combined methods with retrobulbar anaesthesia, peribulbar anaesthesia, subeonjunctival anaesthesia and topical anaesthesia. Group B adopted retrobulbar anaesthesia only. Results The mean time of anesthetic was approximate 181.21 seconds in 53 cases of Group A,and the mean time of anesthetic was approximate 467. 32 seconds in 53 cases of Group B, there were significant differences between two groups （P 〈0.05）. 8 cases of Group A suffered from pain after operation, however,22 cases of Group B suffered from pain during operation or after operation, there were significant differences between two groups （P〈0.05）. The mean time of analgesic lasted for about 200.68 minutes in Group A,and the mean time of ana gesic lasted for about 145. 34 minutes in Group B, there were significant differences between two groups （ P 〈 0. 05 ）. Conclusion The combination of retrobutbar anaesthesia, peribulbar anaesthesia, subeonjunetival anaesthesia and topical anaesthesia has such advantages as the rapid action, the excellent and prolonged analgesic effect, and less cost.