CAJ | 학술논문

目的研究局麻前给予右美托咪啶对于眼科共同性斜视矫正术患者手术前后焦虑及术中牵拉不适的影响.方法选取美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级眼科共同性斜视患者30例,半随机分为两组,对照组(利多卡因结膜下浸润)；用药组:术前静脉给予右美托咪啶1.0 μg/kg,其余同对照组.术前1d及术后1d访视患者并进行焦虑评分(SAS).术中两组进行Ramsay镇静程度评分.用药组术中进行脑电指数(NI)监测麻醉深度.记录两组患者手术时间及牵拉不适情况.结果用药组患者SAS评分术前术后差异有统计学意义(P＜0.05),用药组手术时间较对照组短,对照组有10例,而用药组仅有1例出现牵拉不适(P＜0.05).用药组整个手术过程Ramsay评分为Ⅱ级,生命体征稳定,与医生能很好的配合.结论 1.0 μg/kg的右美托咪啶复合局麻可以很好的满足眼科共同性斜视矫正手术的需要,与局麻患者相比,患者的焦虑明显改善,提高了手术的舒适度且使患者能更好的配合医生操作.
목적 연구국마전급여우미탁미정대우안과공동성사시교정술환자수술전후초필급술중견랍불괄적영향.방법 선취미국마취의사협회(ASA)분급Ⅰ～Ⅱ급안과공동성사시환자30례,반수궤분위량조,대조조(리다잡인결막하침윤)；용약조:술전정맥급여우미탁미정1.0 μg/kg,기여동대조조.술전1d급술후1d방시환자병진행초필평분(SAS).술중량조진행Ramsay진정정도평분.용약조술중진행뇌전지수(NI)감측마취심도.기록량조환자수술시간급견랍불괄정황.결과 용약조환자SAS평분술전술후차이유통계학의의(P＜0.05),용약조수술시간교대조조단,대조조유10례,이용약조부유1례출현견랍불괄(P＜0.05).용약조정개수술과정Ramsay평분위Ⅱ급,생명체정은정,여의생능흔호적배합.결론 1.0 μg/kg적우미탁미정복합국마가이흔호적만족안과공동성사시교정수술적수요,여국마환자상비,환자적초필명현개선,제고료수술적서괄도차사환자능경호적배합의생조작.
Objective To evaluate the effects of Dexmedetomidine on perioperative anxiety and dragging pain for concomitant strabismus surgery administrated before Lidocaine local anesthesia.Methods 30 elective concomitant strabismus patients with American Association of Anesthesia (ASA)score of Ⅰ ～Ⅱwere quasi-randomly divided into 2 equal-sized groups:the control group (Lidocaine subconjunctival infiltration anesthesia) and Dexmedetomidine group (intravenous injection of 1.0 μg/kg Dexmedetomidine before local anesthesia).Patients were visited one day before and after operation,and self-rating anxiety scale (SAS) were recorded.Ramsay score was evaluated for both groups to determine the degree of sedation.Narcotrend monitoring was also performed for Dexmedetomidine group to assess the depth of anesthesia.The operation duration and the perioperative dragging pain were recorded for both groups.Results SAS scores showed significant difference between pre-operative and post-operative periods in Dexmedetomidine group (P＜ 0.05).The Dexmedetomidine group has shorter surgery duration with only one case experienced dragging pain in contrast with 10 cases in the control group (P ＜ 0.05).Dexmedetomidine treatment maintained a Ramsay score of Ⅱ with stable vital signs and well cooperation with ophthalmologist during the operation.Conclusion Dexmedetomidine assisted with Lidocaine local anesthesia provides evident benefits for patients undergoing concomitant strabismus surgery.Compared with simple Lidocaine local anesthesia,dexmedetomidine effectively attenuates perioperative anxiety and provides better cooperation with the ophthalmologists.