表面麻醉下进行超声乳化白内障吸除术对围术期血压水平的影响OA

Objective:To investigate the effect of phacoemulsification for cataract extraction under topical anesthesia on perioperative blood pressure.Method:A total of 327 patients who underwent phacoemulsification+posterior chamber intraocular lens implantation under topical anesthesia performed by the same surgeon in Wuxi Aier Eye Hospital from July 2024 to April 2025 were enrolled in this study.The patients were divided into four groups according to blood pressure levels:normotensive group(69 cases,systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg),high-normal blood pressure group(121 cases,systolic blood pressure 120~139 mmHg and/or diastolic blood pressure 80~89 mmHg),grade 1 hypertension group(105 cases,systolic blood pressure 140~159 mmHg and/or diastolic blood pressure 90~99 mmHg),and grade 2~3 hypertension group(32 cases,systolic blood pressure≥160 mmHg and/or diastolic blood pressure≥100 mmHg).Perioperative blood pressure was compared among the four groups at admission,upon entering the operating room,at the initiation of surgery,at the end of surgery,and postoperatively(when the patients returned to the ward from the operating room for rest).Result:The systolic blood pressure of Group 4 decreased significantly when they entered the operating room compared with that at admission.The systolic blood pressure at the beginning of the operation was significantly higher than that when entering the operating room.At the end of the operation,the systolic blood pressure remained unchanged compared with that at the beginning of the operation.Postoperative systolic blood pressure decreased compared with that at the end of the surgery,and diastolic blood pressure and mean blood pressure also showed a similar trend.The blood pressure change trends of each group were compared.Only the blood pressure of the normal blood pressure group when entering the operating room was higher than that at admission.The blood pressure of the other three groups when entering the operating room was lower than that at admission.Only the systolic blood pressure of the normal blood pressure group decreased after the operation compared with that at the end of the operation.At the end of the operation,there was no significant change in postoperative blood pressure compared with the other three groups.Conclusion:Under topical anesthesia,patients'blood pressure is relatively stable before,during and after surgery.When stratified into normotensive,high-normal,grade 1 hypertension,and grade 2~3 hypertension groups,the trend of blood pressure changes in the normotensive group differs from that in the other three groups.Ophthalmologists should pay attention to unexpected blood pressure fluctuations that may occur during cataract surgery.