不同麻醉方式下斜视手术中眼心反射相关因素的研究

摘要

Objective To observe the changes of heart rate in strabismus surgery under different anesthesia so as to investigate the incidence and the related factors of oculocardiac reflex (OCR) in strabismus surgery under different anesthesia. Methods Sixty-eight cases undergoing strabismus surgery from June 2014 to October 2014 were divided into two groups as needed, the intra-venous potentiated anesthesia group, intravenous general anesthesia group with 34 cases in each. The changes of heart rate during the traction of each extraocular muscle (EOM) before and during the surgery and the incidence of OCR in the patients were ob-served. Results ①The incidence of OCR was lower in intravenous general anesthesia group than that in intravenous potentiated anesthesia group (42.3%vs 61.3%) (P<0.05).②The incidence of OCR was different during the medial rectus, lateral rectus, and inferior oblique muscle surgery. The difference in the incidence of OCR between medial rectus and lateral rectus surgery was not statistically significant (P>0.05). The incidence of OCR between medial rectus, lateral rectus, and inferior oblique muscle surgery under intravenous potentiated anesthesia was statistically significant (P<0.05). ③The incidence of OCR was higher in men than in women, but the difference was not statistically significant (P>0.05). ④ The incidence of OCR was different between different age group, but the difference was not statistically significant in the same anesthesia(P>0.05). Conclusion ①The effect of the two anesthetic methods on the incidence of OCR was different. ②The incidence of OCR was different during the medial rectus, lateral rectus, and inferior oblique muscle surgery.③The different gender or age created the similar small influence on the incidence of OCR.%目的 通过观察不同麻醉方式下斜视手术中心率的变化,了解不同麻醉方式下眼心反射(OCR)发生的几率及OCR的影响因素. 方法 收集2014年6—10月需施行斜视手术的患者,按麻醉需要分静脉强化麻醉、静脉全麻2组,每组34人.观察患者术前和术中牵拉每条眼外肌时的心率的变化及OCR发生率. 结果 ①OCR在静脉全麻组、 静脉强化麻醉组发生率分别为42.3%、61.3%,两者比较差异有统计学意义(P<0.05). ②OCR在内直肌、外直肌、下斜肌手术时的发生率不同;内、外直肌之间的差异无统计学意义(P>0.05),强化麻醉下内、外直肌与下斜肌之间的差异有统计学意义(P<0.05).③OCR在男性与女性的发生率不同;但差异无统计学意义(P>0.05).④不同年龄组的OCR发生率不同,但是在相同的麻醉方式下,其差异无统计学意义(P>0.05). 结论 ①全麻、强化麻醉下OCR发生率有差别.②内、外直肌与下斜肌手术时OCR发生率不同.③男女性别差异、年龄对OCR发生率影响不大.