| Objective:To compare the application effect of simple local anesthesia and local anesthesia combined with intravenous anesthesia in adult strabismus surgery.Methods:This study is prospective.40 patients with strabismus in the First Affiliated Hospital of Nanchang University were included in the study.The general information of the patients was collected,including age,gender,course of disease,degree of prism,weight,type of strabismus diagnosis and so on.According to the order of admission,40 patients were randomly divided into two groups,group A was treated with local anesthesia,group B was treated with local anesthesia plus intravenous anesthesia.All patients were operated by the same chief ophthalmologist,and the data of all patients were recorded and collected by one person:（1）systolic blood pressure,diastolic blood pressure,heart rate,percutaneous oxygen saturation（SpO2）at T1,T2,T3 and T4 were compared between the two groups,as well as the incidence of surgical complications,such as oculocardiac reflex（OCR）、postoperative nausea and vomiting（PONV）、respiratory depression;（2）the pain scores during operation,2h,4h and 8h after operation were compared between the two groups;（3）the muscle operation time of the two groups was compared;（4）the effective rate of strabismus surgery was compared between the two groups 1 day and 1 week after operation.Results:1.General data:there were no significant differences in age,gender,weight,course of disease,visual acuity,degree of prism and diagnosis type of strabismus between the two groups（P>0.05）.2.There was no significant difference in blood pressure,heart rate and SpO2between the two groups at T1,T2,T3 and T4（P>0.05）,but there was significant difference in blood pressure and heart rate at each time point（P<0.05）,and there was no significant difference in SpO2 within group（P>0.05）.The results showed that there was no interaction between time and group in the changes of blood pressure,heart rate and SpO2,that is,the effect of time factors（T1,T2,T3,T4）was not different with the change of grouping（simple local anesthesia group and local anesthesia plus intravenous intensive anesthesia group）.3.The incidence of intraoperative OCR in group A（70%）was higher than that in group B（35%）（P<0.05）.The incidence of PONV in group B（25%）was higher than that in group A（5%）,but the difference was not statistically significant（P>0.05）.There was no respiratory depression in both groups.4.The pain scores in group A were higher than those in group B,and the difference was obvious（P<0.05）.Although the pain score of group A was still slightly higher than that of group B,the difference was not statistically significant（P>0.05）.5.57 and 61 extraocular muscles were operated on in group A and group B respectively.The average operation time of each muscle in group A was longer than that in group B,the difference was statistically significant（P<0.05）.When comparing different surgical methods（external rectus retraction and internal rectus shortening）,the average operative time of each muscle in group A was higher than that in group B,and the difference was statistically significant（P<0.05）.Moreover,the time of external rectus retraction in both groups was shorter than that of shortened internal rectus shortening.6.The results showed that the effective rate of strabismus surgery in group A（100%）was higher than that in group B（95%）,but the difference was not significant（P>0.05）.Conclusions:1.There was no significant difference in the effects of the two anesthesia methods on the blood pressure,heart rate,SpO2 at T1,T2,T3,T4 and respiratory depression,PONV,as well as the treatment effect of strabismus.2.Local anesthesia combined with intensive intravenous anesthesia is safe and effective in strabismus surgery.Compared with simple local anesthesia,it can not only reduce the occurrence of OCR,improve the intraoperative and early postoperative analgesia effect,but also shorten the average operation time required for each muscle. |
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