局麻玻璃体切除术中患者视听觉感受的研究

摘要

Objective To investigate the perception of vision and audition in patients with retrobulbar anesthesia and intravenous potentiated local anesthesia.Methods A prospective study of 209 cases (113 cases in group A,retrobulbar nerve block anesthesia;96 cases in group B,peribulbar anesthesia combined with intravenous potentiated anesthesia) who underwent pars plana vitrectomy in Department of Ophthalmology of Renmin Hospital of Wuhan University were investigated on the first day after operation.The visual and auditory sensation and the effect of anesthesia on them were studied.Results In group A,78.8％ of patients had visual memory,which was significantly higher than that of B group (P ＜0.05).In group A,90.3％ of patients had intraoperative auditory memory,which was higher than that of B group (P ＜0.05).In the retrobulbar anesthesia group,the memories of visual and auditory perception were stronger than that in the potentiated anesthesia group,but the combination of local anesthesia and intravenous potentiated anesthesia was more helpful to reduce anxiety.Conclusions The choice of anesthesia method has a significant influence on the visual and auditory perception of patients undergoing vitrectomy.Local anesthesia combined with intravenous potentiated anesthesia is a better option for patients with anxiety and tension.%目的 通过问卷调查2种不同局麻状态下玻璃体切除术中患者视听觉的感知情况.方法 前瞻性研究.对2015年5月至2016年12月在武汉大学人民医院眼科中心收治的209例(A组113例,球后神经阻滞麻醉;B组96例,球周麻醉加静脉强化麻醉)接受玻璃体切除术的局麻患者在术后第1d进行视听觉问卷调查,研究其在手术过程中视觉和听觉的感受以及麻醉方式对其的影响.结果 A组中有78.8％的患者存在术中视觉记忆,明显高于B组的41.7％ (P＜ 0.05).A组中有90.3％的患者存在术中听觉记忆,高于B组的68.8％ (P＜ 0.05).球后神经组滞麻醉对术中视觉和听觉感知的记忆更强,但球周麻醉加静脉强化麻醉更有助于减轻患者焦虑情绪.结论 麻醉方式的选择对玻璃体切除术中患者的视觉和听觉感知有着明显的影响,对于带有焦虑和紧张情绪的患者,可采用局麻加强化麻醉的方法.