局部麻醉或辅助地西泮在斜视矫正术中的作用

发布时间：2018-06-02 16:05

本文选题：斜视手术 + 地西泮　；参考：《眼科新进展》2015年10期

【摘要】：目的应用面部表情分级评分(face rating scale,FRS)、焦虑评分(self-rating anxiety scale,SAS),观察共同性斜视矫正术患者应用局部麻醉及麻醉前应用地西泮注射液的效果,比较手术前、后的疼痛情况、焦虑、术中牵拉不适及术后随访情况。方法对2012年8月至2014年8月在我院住院的眼科共同性斜视患者88例(108眼),年龄11~40岁,进行显微镜下斜视矫正术,采用随机、对照、双盲的研究方法,随机分为两组:对照组44例54眼(局部注射盐酸罗哌卡因注射液),用药组44例54眼术前辅助肌肉注射地西泮注射液0.2 m L·mg-1。记录术中、术后1 h的FRS、SAS,同时记录术中患者手术时间、牵拉反射及随访情况。结果用药组与对照组患者术中、术后FRS差异均有统计学意义(均为P0.05)。用药组与对照组患者SAS评分术中、术后差异均有统计学意义(均为P0.05)。用药组手术时间较对照组缩短(均为P0.05);用药组患者牵拉反射不适减轻,与对照组差异有统计学意义(P0.05),同时用药组患者手术中生命体征平稳,更好配合医师手术。结论局部麻醉手术辅助术前应用抗焦虑、镇静药物行斜视矫正术具有较好的镇痛效果;明显缓解因术中精神紧张、疼痛及恶心等所致眼位异常,提高手术舒适度、减轻术后不适感,术中医师操作顺利、术后眼位复位较好。
[Abstract]:Objective to observe the effect of local anesthesia and diazepam injection before and after surgery on the patients with concomitant strabismus orthopedic surgery by using facial expression scale rating scale FRSs and self-rating anxiety scalein anxiety scores, and to compare the pain and anxiety before and after operation. Intraoperative tension discomfort and postoperative follow-up. Methods from August 2012 to August 2014, 88 cases (108 eyes) with concomitant strabismus, aged 1140 years, who were admitted to our hospital from August 2012 to August 2014, were treated with strabismus correction under microscope. They were randomly divided into two groups: the control group (44 cases, 54 eyes) received ropivacaine hydrochloride injection (local injection), the drug group (44 cases, 54 eyes) received intramuscular injection of diazepam 0.2 mL mg -1 before operation. The time of operation, traction reflex and follow-up were recorded 1 hour after operation. Results there were significant differences in FRS between the drug group and the control group (P 0.05). There were significant differences in SAS score between the drug group and the control group (P 0.05). The time of operation in the medication group was shorter than that in the control group (all P 0.05), the discomfort of traction reflex in the medication group was alleviated, and the difference between the two groups was statistically significant (P 0.05). Meanwhile, the vital signs of the patients in the medication group were stable during the operation, which was better to cooperate with the physician operation. Conclusion preoperative application of anti-anxiety and sedation drugs in strabismus orthopedic surgery under local anesthesia has a good analgesic effect, significantly alleviates abnormal eye position caused by intraoperative stress, pain and nausea, and improves surgical comfort. Relief of postoperative discomfort, smooth operation, postoperative eye position reduction is better.
【作者单位】：苏北人民医院眼科;苏北人民医院外科;
【分类号】：R779.6

【参考文献】