24180例喉罩全身麻醉下接受眼科手术患儿麻醉复苏期的护理体会

Nursing experience of 24,180 children undergoing ophthalmic surgery under general anesthesia with laryngeal mask during anesthesia recovery period

目的:探讨提高眼科喉罩全身麻醉患儿在麻醉恢复室(post-anesthesia care unit,PACU)复苏质量与效率的整体护理策略。方法:选取2020年1月—2023年12月在中山大学中山眼科中心行眼科全身麻醉并保留喉罩进入PACU复苏的24180例患儿,总结患儿在PACU复苏的护理措施及复苏质量。结果:所有患儿经复苏期综合护理后均顺利拔除喉罩完成麻醉复苏,未发生苏醒期二次插管或非计划转院治疗。采取个性化的整体护理策略后,喉罩全身麻醉患儿PACU平均复苏时间明显缩短。部分术后常见并发症(术后躁动,低氧血症和呼吸道梗阻)和护理不良事件(留置针脱落和眼包脱落)发生率逐年降低,经治疗和护理后均获得改善。结论:针对眼科全身麻醉的患儿特点,在麻醉复苏期采取个性化的整体护理策略,有利于顺利完成麻醉复苏,降低麻醉并发症和护理不良事件的发生率,提高复苏质量效率,满足眼科日间手术快速康复的需求。

Objective:To explore holistic nursing strategies to improve the quality and efficiency of post-anesthesia care unit(PACU)resuscitation in childrenpatients undergoing ophthalmic laryngeal mask anesthesia.Methods:A total of 24,180 children patients who underwent general anesthesia and retained laryngeal mask airway for PACU resuscitation at Sun Yat-sen Ophthalmic Center of Sun Yat-sen University from January 2020 to December 2023 was reviewed and summarized the nursing measures and resuscitation quality of children patients undergoing PACU resuscitation.Results:All patients underwent comprehensive care during the recovery period and successfully removed the laryngeal mask to complete anesthesia recovery.There were no cases of secondary intubation or unplanned transfer for treatment during the recovery period.After adopting personalized holistic nursing strategies,the average recovery time of PACU in children under laryngeal mask anesthesia was significantly shortened.The incidence of common postoperative complications(postoperative agitation,hypoxemia and respiratory obstruction)and adverse nursing events(indwelling needle falls off,eye bandage fall off)had been decreasing year by year.These complications had been improved after treatment and care.Conclusions:Based on the characteristics of children patients undergoing general anesthesia in ophthalmology,adopting personalized holistic nursing strategies during the anesthesia recovery period is beneficial for successfully completing anesthesia recovery,reducing the incidence of anesthesia complications and adverse nursing events,improving the quality and efficiency of recovery,and meeting the needs of rapid recovery in ophthalmic day surgery.