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目的观察术前宣教联合盐酸丙美卡因滴眼液对喉罩全身麻醉下行斜视矫正术患儿的影响。方法选取中国人民解放军第180医院麻醉科2014年4月—2015年9月收治的3~10岁喉罩全身麻醉下行斜视矫正术患儿180例,按照随机数字表法分为无术前宣教及盐酸丙美卡因滴眼液滴眼组(A组)、术前宣教但无盐酸丙美卡因滴眼液滴眼组(B组)、术前宣教联合盐酸丙美卡因滴眼液滴眼组(C组),各60例。A组进行常规护理对照,B、C均进行术前宣教。C组在麻醉后术前及术后覆盖纱布前结膜囊内各滴入0.5%盐酸丙美卡因滴眼液1滴;A、B组在麻醉后术前及术后覆盖纱布前结膜囊内各滴入0.9%氯化钠溶液1滴。术毕清醒拔管,送入麻醉恢复室(PACU)。观察并记录3组患儿术前焦虑情况、苏醒期躁动(EA)发生率及躁动程度,拔除喉罩前(T0)、拔除喉罩即刻(T1)、拔除喉罩后5min(T2)、拔除喉罩后10min(T3)的平均动脉压(MAP)、心率(HR)。结果 C组患儿术前焦虑程度低于A组、B组(P<0.01)。C组EA发生率低于A、B组(P<0.01);B组EA发生率低于A组(P<0.01)。C组EA程度低于A、B组(P<0.01);B组EA程度低于A组(P<0.01)。C组T1、T2、T3时的MAP、HR低于A组、B组(P<0.01)。结论术前宣教联合盐酸丙美卡因滴眼液可明显降低斜视患儿喉罩全身麻醉的EA发生率,并减轻躁动程度,安全有效。
Objective To observe the effect of preoperative mission combined with propamocin hydrochloride eye drops on strabismus correction under general anesthesia in laryngeal mask. Methods A total of 180 children with strabismus underwent general anesthesia for laryngeal mask laryngeal mask surgery from April 2014 to September 2015 admitted to the Chinese People’s Liberation Army 180th Hospital from April 2014 to September 2015 were divided into two groups according to random number table: Propionyl hydrochloride hydrochloride eye drops group (A group), preoperative mission but without propionate hydrochloride eye drops group (B group), preoperative mission combined with propane hydrochloride hydrochloride eye drops Eye group (C group), each 60 cases. A group of routine care control, B, C were preoperative mission. Group C was anesthetized before and after surgery to cover the gauze before the conjunctival sac of each drop of 0.5% propane hydrochloride hydrochloride drops 1; A, B group anesthesia before and after the gauze before the conjunctival sac Each drop of 0.9% sodium chloride solution 1 drop. Clearly surgery extubation, into the anesthesia recovery room (PACU). To observe and record the preoperative anxiety, the incidence of agitation (EA) and the degree of restlessness in the three groups of children, remove the laryngeal mask (T0), remove the laryngeal mask immediately (T1), remove the laryngeal mask after 5min (T2) Mean arterial pressure (MAP), heart rate (HR) at 10 min after laryngeal mask. Results The preoperative anxiety in group C was lower than that in group A and group B (P <0.01). The incidence of EA in group C was lower than that in group A and B (P <0.01). The incidence of EA in group B was lower than that in group A (P <0.01). The level of EA in group C was lower than that in group A and B (P <0.01). The level of EA in group B was lower than that in group A (P <0.01). The MAP and HR in group C at T1, T2 and T3 were lower than those in group A and B (P <0.01). Conclusion Preoperative mission combined with propamocin hydrochloride eye drops can significantly reduce the incidence of strabismus laryngeal mask EA anesthesia EA and reduce the degree of restless, safe and effective.