| Objective To compare the effects of retrobulbar nerve block combined with fast track anesthesia and traditional fast channel general anesthesia on hemodynamics and pain in penetrating keratoplasty patients.method1.We selected 100 patients undergoing penetrating keratoplasty in our hospital from April 2021 to July 2022.2.Data were collected for each patient,including gender,age,height,weight,BMI index,primary disease status,score and other general materials.Patients who meet the enrollment criteria will be divided into observation group and control group.50 patients in each group will have general anesthesia of laryngeal mask ventilation,and patients in the observation group will have retrobulbar nerve block on the basis of the control group.3.The operation time,anesthesia time,awakening time and extubation time were recorded in the two groups.MAP and HR values were recorded before laryngeal mask(T0),(T1),immediately after surgery(T2)and(T3).The use of analgesic and sedative drugs was recorded in both groups.Patients were examined before and 24 h after surgery,including cellular interleukin IL-1β,IL-6,IL-10,and tumor necrosis factor TNF-α.Pain scores(Nmeric rating scales,NRS)at each time point at 2h,6h,12 h and 24 h after surgery in both groups were recorded.The adverse reactions of 24 h after surgery: agitation,eye pulling discomfort,post-operative nausea and vomiting(PONV),and sore throat and other conditions were recorded.4.SPSS23.0 software is used for statistical analysis,and the count data is represented in(x ± s),using independent sample t-test for group comparison;repeated measurement ANOVA for numerical comparison at various time points.Count data are expressed as examples and percentage,with a chisquare test performed at α =0.05.Results1.General data: No significant difference in gender,age,body quality index(BMI),ASA grade,and the type of primary disease occurred(P> 0.05).In the observed group,remifentanl and propofol were lower than in the control group and were statistically significant(P <0.05).2.The consumption of remifentanil and propofol in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).3.During the operation,the time of anesthesia,awakening and extubation was significantly shorter compared to the control group,which was significantly different(P<0.05).Although the operation time of the two groups was decreased,the difference was not statistically significant(P> 0.05).4.In terms of MAP,within-group comparison: the T 1-T 3 difference between T0 and T0(P<0.05).The MAP was decreased in both T1-T3 groups(P <0.05),and the lowest value appeared at T2.Group comparison: at the T0 and T1 time points,the comparison between the two MAP groups was not different(P> 0.05).MAP at T2 and T3 were offset compared with the control group(P <0.05).In terms of HR,within-group comparison: after the T0 time point,the HR in both T1-T3 groups decreased(P<0.05),and the lowest value appeared at the T2 time point,and the difference was statistically significant(P<0.05).Comparison between groups: T0 time point,the difference between MAP groups(P>0.05),T1,T2,T3 time point,the HR of the observation group was lower than the control group,the difference was statistically significant (P<0.05).5.There was no significant difference in the preoperative inflammatory factor levels between the two groups,but the IL-1 β,IL-6,IL-10,and TNF-αlevels at 24-h in the observed group were significantly lower than those in the control group(P<0.05).6.Comparison of pain scores,intra-group comparison: compared with 2h,the difference between 6h,12 h and 24h(P<0.05),no statistical difference between 6h and 2h(P>0.05),and no statistical difference between 12 h and 2h(P> 0.05).The observation group was first increased,then decreased,and the highest value appeared at 6h after surgery.The observation group continued high values,gradually decreased.Comparison between groups: At the 2h and6 h postoperative time points,the scores of the observation group were lower than that of the control group(P<0.05),and there was no significant difference between the two group scores at 12 h and 24h(P>0.05).The observed and control groups(P>0.05).7.There was no significant difference in the incidence of postoperative complications between the observation group and the control group(P>0.05).Conclusion1.Pobulbar nerve block combined with fast passage general anesthesia,applied to patients with penetrating keratoplasty,can not only reduce the amount of anesthetic,reduce postoperative pain,shorten postoperative waking time,reduce inflammatory response,but also better help to stabilize hemodynamic indicators.2.The postoperative complication incidence of retrobulbar nerve block combined with fast-passage general anesthesia does not increase,and the safety is high,which is suitable for clinical application. |
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