奥布卡因滴眼联合苏醒后术眼覆盖对斜视患儿全麻术后躁动的影响

Effect of administration of oxybuprocaine hydrochloride eye drops plus covering of the operated eye upon awakening from anesthesia on postoperative agitation in children receiving strabismus surgery under general anesthesia

目的探讨不同护理措施对斜视患儿全麻术后躁动的作用。方法选择3~12岁全身麻醉下行斜视矫正术的患儿696例,随机分为观察组和对照1、2组各232例,观察组在手术结束时于患儿结膜囊内滴入0.4%盐酸奥布卡因滴眼液1滴,手术眼无敷料覆盖送入麻醉恢复室,待患儿苏醒后与其沟通将敷料粘贴于眼部上方;对照1组手术结束时于患儿结膜囊内滴入0.4%盐酸奥布卡因滴眼液1滴,手术眼覆盖送入麻醉恢复室;对照2组在手术结束时直接将手术眼覆盖送入麻醉恢复室。观察并记录患儿苏醒期躁动的发生情况,评估发生躁动的程度。结果观察组躁动发生率8.6%,对照1组躁动发生率13.8%,对照2组躁动发生率为35.8%,三组比较差异有统计学意义(P<0.01)。结论手术眼滴0.4%盐酸奥布卡因联合苏醒后覆盖术眼对斜视患儿术后躁动有较好的预防作用。

Objective To observe the effect of different nursing measures on postoperative agitation in children after strabismus surgery under general anesthesia.Methods A total of 696 children aged 3-12 years who were to receive strabismus correction surgery under general anesthesia were randomly divided into 3 groups:the intervention group,the control group 1,and 2.The intervention group received one drop of 0.4%oxybuprocaine hydrochloride at the end of the operation,and was sent to post-anesthesia care unit(PACU)with the operated eye left uncovered with dressing.When they emerged from anesthesia,the nurses communicated with them,and then covered the operated eye with dressing.The control group 1 received one drop of 0.4%oxybuprocaine hydrochloride at the end of the operation,and was sent to PACU with the operated eye covered with dressing,while the control group 2 was sent to PACU with the operated eye covered with dressing at the end of the operation without receiving 0.4%oxybuprocaine.The incidence and degree of emergence agitation among the 3 groups were recorded.Results The incidence rate of emergence agitation in the intervention group was 8.6%,versus 13.8%in the control group 1,and 35.8%in the control group 2,showing significant diffe-rence(P<0.05).Conclusion The combination of 0.4%oxybuprocaine hydrochloride at the end of the operation and covering the surgical eye upon awakening from anesthesia has an excellent preventive effect on emergence agitation in children receiving strabismus surgery.