喉罩复合七氟醚麻醉在小儿门诊全身麻醉眼底荧光素造影检查中的应用

Application of inhaled sevoflurane via laryngeal mask airway in children undergoing outpatient fundus fluorescein angiography with general anesthesia

目的:观察喉罩通气吸入七氟醚麻醉在小儿眼底荧光素造影检查(fundus fluorescein angiography,FFA)期间眼位情况、眼球运动的发生率和丙泊酚调整眼位的有效率。方法:回顾性分析2018年6月至2019年1 2月七氟醚麻醉下接受F FA的儿童的病例资料,记录检查开始时眼位分级、检查中眼球运动发生率、丙泊酚调整眼位的有效率、麻醉后恢复自主活动时间以及不良事件。结果:纳入1~9岁患儿54例,检查开始时42.6%(23/54)的患者眼位1级,51.9%(28/54)的患者眼位2级,5.6%(3/54)的患者眼位3级,检查中眼球运动发生率为61.1%(33/54)。13%(7/54)的患儿需丙泊酚干预,丙泊酚1mg/kg纠正眼位的有效率为100%。患儿麻醉后恢复正常活动的平均时间为24.4min,未发生不良事件。结论:喉罩复合七氟醚的麻醉可为门诊小儿眼底荧光造影提供相对满意的麻醉质量,患者在麻醉后可迅速恢复日常活动,丙泊酚可迅速纠正检查中眼位不正。

Objective:To observe the eye position,the incidence of eye movement and the efficacy of propofol on correcting eccentric eyeball position in children undergoing examination of outpatient fundus fluorescein angiography(FFA) with inhaled sevoflurane via laryngeal mask airway.Methods:Children undergoing FFA with sevoflurane anesthesia from June 2018 to December 2019 were retrospectively reviewed.Eye position at the beginning of examination,incidence of eye movement during examination,the efficiency of propofol on correcting eccentric eyeball position during procedure,the time to resume normal activities,and adverse events were recorded.Results:Fifty-four children aged 1-9 years were included in this study.The rates of eye position from grade one to grade three at the beginning of examination were 42.6%(23/54),51.9%(28/54),and 5.6%(3/54),respectively.The incidence of eye movement during examination was 61.1%(33/54).13%(7/54) of children with unsatisfactory eye-position needed intervention with propofol.The efficacy of propofol(1 mg/kg) in correcting eye position was 100%.The mean time to return normal activities was 24.4 min.There were no any adverse events during the peri-anesthetic period.Conclusion:Inhaled sevoflurane via LMA can provide appropriate anesthesia for outpatient FFA in children.Children can resume daily activities soon after anesthesia.Propofol can return the incorrect eye position during examination.