唤醒麻醉在青少年斜视矫正术中的运用研究

发布时间：2018-07-17 17:50

【摘要】：目的：观察唤醒麻醉联合球结膜下注射利多卡因麻醉和单纯使用球结膜下注射利多卡因麻醉在青少年水平共同性斜视及复杂非共同性斜视的手术病例中的镇痛作用及对手术效果的影响。方法：收集自2012年6月至2013年3月来我科行斜视矫正术的15-25岁青少年病例共91例。分为三组,其中70例单纯水平共同性斜视随机分为2组,21例复杂非共同性斜视分到第三组。采用的麻醉方法：组1和组3病人,采取唤醒麻醉联合球结膜下注射1%利多卡因麻醉；组2病人单纯予1%利多卡因球结膜下注射麻醉。三组病人均在术中予松解缝线观察眼位,并对效果欠佳的病人行微调后缝合球结膜。术后1小时以内对病人用改良数字评估法进行痛觉评估,并在术后一周、一个月、三个月左右复查手术疗效。结果：将三组病例的痛觉评估行统计学分析,证明唤醒麻醉联合局部麻醉镇痛效果明显优于单纯局部麻醉。将组1和组2术后斜视度复查做对比分析,发现两种麻醉方法对术后疗效影响无显著差异。结论：术中唤醒麻醉联合球结膜下注射利多卡因麻醉可以有效的降低患者术中疼痛及不适。相比传统的单纯球结膜下注射利多卡因麻醉,镇痛效果更好。同时,由于2类麻醉都可以实现在术中观察手术效果,并及时微调,因此术后斜视均能达到有效矫正。
[Abstract]:Objective: To observe the analgesic effect and effect of lidocaine anesthesia combined with subconjunctival injection of lidocaine anesthesia combined with subconjunctival injection of lidocaine in the operation cases of adolescent horizontal concomitant strabismus and complex non concomitant strabismus.
Methods: a total of 91 cases of 15-25 year old adolescents with strabismus correction from June 2012 to March 2013 were divided into three groups, of which 70 cases were divided into 2 groups, 21 cases of complex non common strabismus were divided into third groups. The anesthesia methods were used in group 1 and 3 patients, with wake anaesthesia combined with conjunctival injection. 1% lidocaine anesthesia was shot; group 2 patients were given subconjunctival anesthesia with only 1% lidocaine. The three patients were treated with loosing suture and observed the eye position in the operation, and the patients who had poor effect were sutured with the conjunctiva. The patients were assessed with improved digital evaluation within 1 hours after the operation, and one week, one month, three after the operation. The effect of the operation was reviewed around the month.
Results: the pain evaluation of three groups of cases was statistically analyzed. It was proved that the analgesic effect of the wake anaesthesia combined with local anesthesia was obviously better than that of the simple local anaesthesia. Group 1 and group 2 were compared and analyzed after the reexamination of the strabismus, and there was no significant difference in the effect of the two anesthesia methods on the postoperative effect.
Conclusion: intraoperative anesthesia combined with lidocaine anesthesia combined with subconjunctival injection of lidocaine can effectively reduce the pain and discomfort in the operation. Compared with the traditional subconjunctival injection of lidocaine, the analgesic effect is better. At the same time, the effect of hand operation can be observed during the 2 types of anaesthesia, and it can be adjusted in time, so the postoperative strabismus is all Effective correction can be achieved.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R614

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