中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
Chinese Journal of ocular trauma and occupational eye disease
2015年
9期
671-673
,共3页
秦廷玉%高莎莎%陈佳佳%李福祯%罗欢%张栋%王文战
秦廷玉%高莎莎%陳佳佳%李福禎%囉歡%張棟%王文戰
진정옥%고사사%진가가%리복정%라환%장동%왕문전
眼科手术,眼后段%麻醉,球后,联合%上直肌%滑车神经
眼科手術,眼後段%痳醉,毬後,聯閤%上直肌%滑車神經
안과수술,안후단%마취,구후,연합%상직기%활차신경
Ophthalmic surgery,posterior segment%Anesthesia,retrobulbar,combined%Superior rectus muscle%Trochlear nerve
目的 探讨球后麻醉联合上直肌和滑车神经麻醉在眼后段手术中的应用效果.方法 眼后段手术682例(700眼).先以传统的经皮肤球后麻醉法注射麻药1.5ml,再行上直肌麻醉,由眶上缘中部从结膜囊穹隆部进针沿眼球壁至角膜缘后约8 mm上直肌止点后方,注入麻药0.5 ～1ml,最后行滑车神经麻醉,由眶上缘及眶内缘连接处从结膜囊进针,进针深度20 mm,靠近上斜肌,注入麻药1 ～1.5 ml.结果 麻醉效果良好者685眼,占97.86％;麻醉效果欠佳者15眼,占2.14％,引起球后出血者5眼,占0.71％.结论 球后麻醉联合上直肌和滑车神经麻醉可使眼球处于水平正视位,固定良好,无需牵引线.更重要的是在眼后段手术时,此种联合麻醉法疼痛感明显减轻,使眼后段手术顺利进行,并减少了麻醉的并发症.
目的 探討毬後痳醉聯閤上直肌和滑車神經痳醉在眼後段手術中的應用效果.方法 眼後段手術682例(700眼).先以傳統的經皮膚毬後痳醉法註射痳藥1.5ml,再行上直肌痳醉,由眶上緣中部從結膜囊穹隆部進針沿眼毬壁至角膜緣後約8 mm上直肌止點後方,註入痳藥0.5 ～1ml,最後行滑車神經痳醉,由眶上緣及眶內緣連接處從結膜囊進針,進針深度20 mm,靠近上斜肌,註入痳藥1 ～1.5 ml.結果 痳醉效果良好者685眼,佔97.86％;痳醉效果欠佳者15眼,佔2.14％,引起毬後齣血者5眼,佔0.71％.結論 毬後痳醉聯閤上直肌和滑車神經痳醉可使眼毬處于水平正視位,固定良好,無需牽引線.更重要的是在眼後段手術時,此種聯閤痳醉法疼痛感明顯減輕,使眼後段手術順利進行,併減少瞭痳醉的併髮癥.
목적 탐토구후마취연합상직기화활차신경마취재안후단수술중적응용효과.방법 안후단수술682례(700안).선이전통적경피부구후마취법주사마약1.5ml,재행상직기마취,유광상연중부종결막낭궁륭부진침연안구벽지각막연후약8 mm상직기지점후방,주입마약0.5 ～1ml,최후행활차신경마취,유광상연급광내연련접처종결막낭진침,진침심도20 mm,고근상사기,주입마약1 ～1.5 ml.결과 마취효과량호자685안,점97.86％;마취효과흠가자15안,점2.14％,인기구후출혈자5안,점0.71％.결론 구후마취연합상직기화활차신경마취가사안구처우수평정시위,고정량호,무수견인선.경중요적시재안후단수술시,차충연합마취법동통감명현감경,사안후단수술순리진행,병감소료마취적병발증.
Objective To investigate the application effect of retrobulbar anesthesia combined with superior rectus and trochlear nerve anesthesia in posterior segment ophthalmic operation.Methods Seven hundred eyes of 682 cases with posterior segment eye surgery were chosen.The traditional trans-skin retrobulbar anesthesia (the anesthetic dose:1.5 ml) was applied at first and the superior rectus muscle anesthesia (the anesthetic dose:0.5-1 ml) was used,and combined with the trochlear nerve block anesthesia (the anesthetic dose:1-1.5 ml).Then,the movement of eye was observed.Results The effect of anesthesia was good in 685 eyes accounting for 97.86％ and was bad in 15 eyes accounting for 2.14％.Retrobulbar hemorrhage appeared in 5 eyes,accounting for 0.71％.Conclusion Retrobulbar anesthesia combined with superior rectus and the trochlear nerve anesthesia can make the eyeball to the horizontal position and can fix the eyeball well without the superior rectus traction suture.More importantly,this kind of combined anesthesia in the posterior segment operation reduces the pain obviously,and reduces the complications related to the anesthesia.
