个性化麻醉方式在小切口白内障囊外摘除手术中的效果研究

Effect study of personalized anesthesia on small incision extracapsular cataract extraction

目的研究个性化麻醉方式在小切口白内障摘除手术中的临床效果。方法选择我院2010年1月2011年11月的白内障患者96例,所有患者均行小切口白内障囊外摘除手术,通过术前综合评价,选择适宜的麻醉方式,将所有患者分为球后麻醉(7例)、表面麻醉(54例)和表面麻醉联合球结膜下浸润麻醉(35例),观察对比三种麻醉方式的效果。结果球后麻醉的7例患者及表面麻醉加结膜下浸润麻醉35例患者均麻醉良好;表面麻醉50例患者麻醉良好,4例表面麻醉患者中2例术中感疼痛,瞬目反射敏感,2例眼球不自主转动,手术配合不佳,麻醉不足;术中2例追加结膜下麻醉,2例改为球后麻醉。结论表面麻醉加结膜下浸润麻醉在小切口白内障囊外摘除手术中具有较好效果,可作为其的最佳麻醉方式。

Objective To investigate the clinical effect of personalized anesthesia on small incision extracapsular cataract extraction. Methods From January 2010 to November 2011, 96 patients with cataract were enrolled, and all the patients underwent small incision extraeapsular cataract extraction, through the preoperative comprehensive evaluation, the appropriate anesthesia methods were selected and patients were grouped into retrobulbar anesthesia （7 cases）, surface anes- thesia （54 cases）, surface anesthesia combined with subconjunetival anesthesia （35 cases）, the anesthetic effects were ob- served and compared in the three methods. Results Seven patients underwent retrobulbar anesthesia and 35 cases under- went surface anesthesia combined with subconjunetival anesthesia had good anesthetic effects; 50 cases underwent surface anesthesia had good anesthetic effect, and of 4 cases underwent surface anesthesia, 2 cases had intraoperative pain and was sensitive to the blink reflex, while 2 cases had eyeball involuntary rotation and poor surgical coordination, the anesthesia was inadequate; and then 2 cases appended subconjunetiva] anesthesia, 2 cases underwent retrobulbar anesthesia. Conclu- sion Surface anesthesia combined with subconjunctival anesthesia has better effect on small incision extracapsular cataract extraction, which can be used as the best anesthesia methods.