肌松药物对喉罩全身麻醉下老年日间白内障手术患者术后复苏的影响OA
Influence of muscle relaxants on postoperative recovery in elderly patients undergoing day-case cataract surgery under laryngeal mask general anesthesia
目的:探讨肌松药物对喉罩全身麻醉下老年日间白内障手术患者术后复苏的影响,为老年日间白内障手术患者的麻醉合理用药提供临床参考.方法:收集 2024 年 1 月—2025 年 6 月于中山大学中山眼科中心在喉罩全身麻醉下接受白内障超声乳化抽吸术联合人工晶体一期植入手术的老年患者 144 例.根据患者使用肌松药物与否分为观察组(51 例,未使用肌松药物)和对照组(93 例,使用肌松药物).收集患者喉罩拔除时间、麻醉复苏室(post-anesthesia care unit,PACU)停留时间和住院时间、不同时间点的血流动力学水平和呼吸参数变化;记录围术期血管活性药物累积使用量、围术期不良事件发生率等.结果:观察组的喉罩拔除时间、PACU停留时间及住院时间均短于对照组(P<0.05).观察组收缩压(systolic biood pressure,SBP)或舒张压(diastolic biood bressure,DBP)、潮气量(volume tidal,VT)及气道峰压(peak inspiratory pressure,Ppeak)在手术开始时(T2)、手术开始 5 min时(T3)、手术结束时(T4)均低于对照组(P<0.05);观察组术中最高呼气末二氧化碳分压(end-tidal carbon dioxide pressure,PetCO2)高于对照组(P<0.05).两组患者复苏期均未发生严重并发症以及术中均未出现体动和需要更改麻醉方式的病例(P>0.05).是否使用肌松药是麻醉复苏停留时间的影响因素(P<0.001).结论:不采用肌松药物的喉罩全身麻醉可安全用于老年白内障超声乳化抽吸术联合人工晶体一期植入手术中,能缩短患者喉罩拔除时间、PACU停留时间和住院时间.
Objective:To investigate the impact of muscle relaxants on postoperative recovery in elderly patients undergoing day-case cataract surgery under laryngeal mask general anesthesia.This study aims to provide a clinical reference for the rational use of anesthetic drugs in this patient population.Methods:A total of 144 elderly patients who underwent phacoemulsification with intraocular lens implantation under laryngeal mask general anesthesia at our hospital from January 2024 to June 2025 were collected.Patients were divided into an Observation Group(51 cases,no muscle relaxants used)and a Control Group(93 cases,muscle relaxants used).We collected data on the time to laryngeal mask removal,Post-Anesthesia Care Unit(PACU)stay time,and length of hospital stay.Hemodynamic parameters and respiratory variables were recorded at different time points.The cumulative dose of perioperative vasoactive drugs and the incidence of perioperative adverse events were also documented.Results:The time to laryngeal mask removal,PACU stay time,and hospital stay were all significantly shorter in the Observation Group compared to the Control Group(P<0.05).SBP,DBP,VT,and Ppeak were lower in the Observation Group at the beginning of surgery(T2),five minutes after the start of surgery(T3),and at the end of surgery(T4)compared to the Control Group(P<0.05).The highest intraoperative PetCO2 in the Observation Group was significantly higher than in the Control Group(P<0.05).There were no severe complications or intraoperative body movements that required a change in anesthetic method in either group during the recovery period(P>0.05).Among all factors that could influence PACU stay time,the use of muscle relaxants was a significant factor with a statistically significant difference(P<0.001).Conclusions:Laryngeal mask general anesthesia without the use of muscle relaxants can be safely applied in elderly patients undergoing phacoemulsification with intraocular lens implantation.It helps to shorten the time to laryngeal mask removal,PACU stay time,and length of hospital stay.
刘慧琴;罗燕华;杜新月;郭敏;谢祝斌;甘小亮
中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060
医药卫生
肌松药物喉罩全身麻醉老年白内障手术
muscle relaxantslaryngeal mask airwaygeneral anesthesiaelderlycataract surgery
《眼科学报》 2026 (2)
62-73,12
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