全身麻醉术后视物模糊的影响因素分析

Factors related to blurred vision after general anesthesia

目的分析全身麻醉患者术后出现视物模糊的影响因素。方法回顾性分析平湖市第一人民医院2022年9月至2023年5月择期行全身麻醉患者997例的临床资料,收集患者年龄、性别、身体质量指数(BMI)、美国麻醉医师协会(ASA)分级、高血压病史、糖尿病病史、手术时间(是否>3 h)、手术体位(是否为平卧位)、手术室室温、是否使用戊乙奎醚、是否使用肌松拮抗剂、术中是否使用阿托品、血压波动是否剧烈(≥30%基础值)、手术补液量、术中失血量、术中是否使用气腹16个可能影响因素。通过共线性诊断,单因素logistic回归分析筛选有统计学意义的因素再行多因素logistic回归分析。结果单因素及多因素logistic回归分析示:年龄>65岁(OR=1.47,95%CI:1.01~2.15,P=0.043),手术体位(非平卧位)(OR=1.54,95%CI:1.06~2.25,P=0.025),手术时间(>3 h)(OR=1.76,95%CI:1.05~2.94,P=0.031)及使用戊乙奎醚(OR=4.91,95%CI:3.35~7.21,P<0.001)是导致全身麻醉患者术后出现视物模糊的影响因素。结论患者年龄>65岁,术中戊乙奎醚的使用和全身麻醉下手术时间>3 h及手术体位(非平卧位)是全身麻醉患者术后出现视物模糊的影响因素,临床需早期科学采取术前宣教,提高术中护理质量,优化全身麻醉术前用药等措施,减少全身麻醉后视物模糊的发生。

Objective To analyze the influential factors of blurred vision after general anesthesia.Methods The clinical data of 997 patients who underwent elective general anesthesia at The No.1 People's Hospital of Pinghu from September 2022 to May 2023 were retrospectively analyzed.The data collected included age,sex,body mass index,American Society of Anesthesiologists classification,history of hypertension,history of diabetes,operation duration(specifically whether it exceeded 3 hours),surgical position(whether the patient was in the supine position),operating room temperature,use of penehyclidine hydrochloride,use of muscle relaxant antagonists,use of atropine,blood pressure(specifically whether it was≥30%of the baseline value),fluid input,blood loss,and use of pneumoperitoneum.Collinearity diagnosis and univariate logistic regression analysis were conducted to select factors with statistical significance.Subsequently,multivariate logistic regression analysis was performed.Results Univariate and multivariate logistic regression analyses showed that age>65 years(OR=1.47,95%CI:1.01-2.15,P=0.043),surgical position(non-supine position)(OR=1.54,95%CI:1.06-2.25,P=0.025),operation time exceeding 3 hours(OR=1.76,95%CI:1.05-2.94,P=0.031),and the use of penehyclidine hydrochloride(OR=4.91,95%CI:3.35-7.21,P<0.001)were identified as factors contributing to postoperative blurred vision in patients undergoing general anesthesia.Conclusion Factors contributing to postoperative blurred vision in patients undergoing general anesthesia include age>65 years,the use of penehyclidine hydrochloride during surgery,operation time exceeding 3 hours,and non-supine surgical position.Clinically,it is essential to implement early and effective preoperative education,enhance intraoperative nursing quality,and optimize preoperative medication for general anesthesia to reduce the incidence of blurred vision after surgery.