摘要
目的研究氯胺酮、丙泊酚用于眼睑整形手术中麻醉的可行性。方法2014年11月至2015年11月我院进行的双眼重睑成形术联合内眦开大术的120位年轻女患者，按单双号随机分为两组，每组60例。临床试验组术前给予静脉滴注氯胺酮（0．4—0．55mg／kg）和丙泊酚（0．4—0．55m马／kg），待受术者进入睡眠状态后，用2％利多卡因、10％罗哌卡因（二者容积比1：1）和肾上腺素（100000；1）混合液行眼睑局部浸润麻醉。对照组术前仅用上述药物行眼睑局部浸润麻醉。采用数字疼痛分级法，分别记录两组于术中局部浸润麻醉时、术后1、2、6、12及24h的疼痛分级，采用t检验分析两组疼痛差异有无统计学意义。同时记录试验组术中及术后不良反应。结果试验组和对照组术中、术后1、2及6h的疼痛差异有统计学意义；试验组术后不良反应如恶心、呕吐和疼痛发生率较低。结论眼睑整形手术前给予氯胺酮和丙泊酚，对于术中及术后有良好的镇痛、镇静作用，术中及术后不良反应少，是一种较安全、元痛的麻醉方法。
Objective To study the feasibility of applying ketamine and propofol for anesthesia in eyelid plastic surgery. Methods A total of 120 young female patients were enrolled. They underwent both eyelid plasty combined with medial canthoplasty. Sixty volunteers served randomly as clinical trail group and the rest as the control group. In clinical trail group, intravenous ketamine（0.40 -0.55 mg/kg）and propofol （0.40- 0.55 mg/kg） were given slowly before operation. When the recipients lost consciousness, the operator injected local anesthetic mixture into the subcutaneous eyelid. The mixture comprised 2% lidocaine, 10% ropivacaine （Volume 1：1 ） and epinephrine （100 000：1 ）. The control group was given local anesthesia. Numeric pain rating scale（NRS） was used to record the recipients＇ pain score during the local injection, 1 h, 2 h, 6 h, 12 h and 24 h after surgery. The difference of patients＇ pain score between the two groups was not statistically significant. The adverse reactions during and after surgery were recorded. Results There was significant difference between the two groups in the severity of pain during the local injection, 1 h, 2 h, 6 h following surgery. The rates of adverse reactions such as nausea and vomiting in clinical trail group were lower. Conclusion Intravenous ketamine and propofol before the eyelid plastic surgery is effective for sedation and analgesic during and after surgery. It is worthy of clinical promotion because of safety, painlessness and less adverse events.
作者
周蓓清
沙青锋
杨晓珂
杨红涛
付梦凯
王银龙
孔宇
Zhou Beiqing Sha Qinffeng Yang Xiaoke Yang Hongtao Fu Mengkai Wang Yinlong Kong Yu(Department of Ocular Plastic, Zhengzhou Municipal Second People＇ s Hospital, Zhengzhou 450006, Chin)
出处
《中华眼外伤职业眼病杂志》
2017年第2期126-129,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
麻醉
无痛
氯胺酮
丙泊酚
整形手术
眼睑
疼痛分级
Anesthesia, painless
Ketamine
Propofol
Plastic surgery, eyelid
Pain scale
