成人斜视手术中不同局部麻醉方式的疗效分析

Analysis the effect of different local anesthesia in adult strabismus surgery

目的观察单纯局部麻醉和局麻联合右旋美托咪定静脉给药下成人斜视手术的疗效。方法选取2017年4月至2017年11月于我院眼科行斜视矫正术的74例成人患者作为研究对象,其中单纯局麻组35例,局麻联合右旋美托咪定静脉给药组39例,观察并分析两组患者术中眼心反射(OCR)发生率、平均动脉压(MAP)、术后视觉模拟疼痛评分(VAS)及术后6个月时的临床治愈率。结果局麻联合静脉给药组眼心反射阳性率、VAS评分明显低于单纯局麻组,差异均有统计学意义(P <0. 05);两组术后6个月临床治愈率存在差异(P <0. 05),其中局麻联合静脉给药组临床治愈率达89. 7%,单纯局麻组则为62. 9%;两组患者术中MAP变化差异无统计学意义。结论在成人斜视手术中,采用局麻联合右旋美托咪定静脉麻醉能降低术中眼心反射发生率,提高斜视手术的短期临床治愈率,并且具有良好的镇静镇痛效果。

Objective To study the efficacy of local anesthesia or combined with dexmedetomidine on adult strabismus surgery. Methods A total of 74 adult patients who underwent strabismus surgery from April 2017 to November 2017 were selected as our study subjects,divided them into two groups according to the anesthesia method. 35 cases received local anesthesia alone, 39 cases received local anesthesia combined with dexmedetomidine. The incidence of the oculocardiac reflex and mean arterial pressure (MAP)during surgery, immediate postoperative visual analog scale(VAS), clinical cure rate at 6 months after surgery were studied. Results The rate of oculocardiac reflex and the VAS of the combined anesthesia group were significantly lower than those in the local anesthesia group ( P <0.05). There was a difference in the clinical cure rate between the two groups at 6 months ( P <0.05), and the clinical cure rate was 89.7% in the combined anesthesia group and 62.9% in the local anesthesia group; There was no significant difference in intraoperative MAP changes between the two groups. Conclusions Local anesthesia combined with dexmedetomidine was effective in adult strabismus surgery, which can reduce the incidence of oculocardiac reflex and intraoperative pain, improve the short-term clinical cure rate.