全身麻醉下使用肌肉松弛药对外斜视儿童眼位的影响

Effect of Muscle Relaxants on Eye Position in Children with Exotropia During General Anesthesia

目的:探讨全身麻醉中使用肌肉松弛药物对外斜视儿童眼位的影响。方法:选取2021年9月-2023年3月笔者医院收治的2~12岁行全身麻醉(静脉给药)手术的外斜视患儿80例作为研究对象,按照是否应用肌肉松弛药物分为A组和B组,各40例,A组应用肌肉松弛药,B组不应用肌肉松弛药。应用角膜映光法测定两组患儿全身麻醉前、麻醉操作后即刻眼位及手术过程中在脑电双频指数(Bispect ral index,BIS)监测下测定浅、中、深度麻醉期的患儿眼位。结果:两组麻醉操作后即刻角膜映光法测定的眼位外斜度较麻醉前增加,但A组眼位外斜度较B组眼位外斜度小(P<0.05);两组BIS监测不同麻醉深度下眼位对比差异有统计学意义,随着麻醉深度的增加,眼位外斜度增加,且A组各麻醉深度下眼位外斜度较B组小(P<0.05)。结论:全身麻醉会对外斜视儿童眼位造成影响,但肌肉松弛药的使用会削弱这种影响。且不同麻醉深度也会影响外斜视儿童眼位,相较于中度麻醉期和深度麻醉期,浅度麻醉期患儿眼位影响更小。

Objective To investigate the effect of muscle relaxation drugs on the eye position of children with exotropia under general anesthesia.Methods A total of 80 children with exotropia aged 2 to 12 years old who were expected to undergo general anesthesia(intravenous administration)surgery in the author's hospital during the three years from September 2021 to March 2023 were selected as the study objects.The patients were divided into group A and Group B according to whether muscle relaxants were used or not,with 40 cases in each group.Group A received muscle relaxants and group B did not receive muscle relaxants.The eye position of the children under shallow,medium and deep anesthesia was measured by keratorimetry before and immediately after anesthesia,and the eye position of the children under shallow,medium and deep anesthesia was measured by BIS during operation.Results The external inclination of the eye measured by keratography immediately after anesthesia in both groups was higher than that before anesthesia,but the external inclination of the eye in group A was lower than that in group B(P<0.05).There was A statistical difference between the two groups in BIS monitoring eye position under different anesthesia depths.With the increase of anesthesia depth,the external inclination of eye position increased,and the external inclination of eye position under each anesthesia depth was smaller in group A than in group B(P<0.05).Conclusion General anesthesia can affect the eye position of children with exotropia,but the use of muscle relaxants can weaken this effect.Different depth of anesthesia can also affect the eye position of children.Compared with moderate anesthesia and deep anesthesia,the eye position of children in light anesthesia is less affected.