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1.
目的观察眼球筋膜囊下麻醉在小切口青光眼白内障联合术中的效果。方法32例(34眼)青光眼合并白内障采用眼球筋膜囊下麻醉行小切口青光眼白内障联合手术,观察术中麻醉效果,术后视力、眼压,随访3-12个月。结果术中无疼痛,配合良好。顺利完成手术者30眼(88.24%),轻度疼痛但可忍受,能配合完成手术者4眼(11.76%)。术后视力明显提高,术后6个月复查眼压控制良好。结论眼球筋膜囊下麻醉行小切口青白联合术治疗青光眼合并白内障安全有效。  相似文献   

2.
表面麻醉下白内障超声乳化术中的心电监护   总被引:4,自引:0,他引:4  
目的:评价表面麻醉在白内障超声乳化人工晶状体植入术中的效果及对心血管系统的影响。方法:观察84例(87眼)表面麻醉下手术中的麻醉效果、心电监护及术后视力。结果:术组全部病例均在表面麻醉下完成手术,手术前后患者的血压、脉搏均无显著变化。术后视力第1天0.5者25眼(28.73%),1周≥0.5者56眼(63.36%),1月≥0.5者69眼(79.31%)。结论:表面麻醉可使白内障手术更加简便、安全、舒适,并更快恢复视力。老年白内障患者中心电监护对提高手术安全性十分重要。  相似文献   

3.
目的 观察青光眼合并白内障行超声乳化联合手术的临床疗效。方法 球周麻醉加表面麻醉下,对20例(23眼)青光眼合并白内障患者行超声乳化白内障摘除人工晶体植入小梁切除三联术。结果 术后1周视力:〈0.1者3眼,0.1~0.3者7眼,〉0.3者13眼;其中〉0.5者10眼。术后眼压正常者18眼(78.3%);术后眼压偏高2眼;术后低眼压3眼。结论联合手术治疗青光眼合并白内障是安全、有效的。  相似文献   

4.
目的 探讨幼儿白内障手术采用表面麻醉,球后麻醉联合氯胺酮麻醉的方法和效果。方法 对6月~4岁幼儿白内障手术32例52眼采用0.5%爱尔卡因滴眼液表麻,联合氯胺酮肌肉注射麻醉,待患儿入睡后进行球后麻醉。手术方式为白内障针吸术和白内障超声乳化术,术中观察心率、呼吸、血压、氧饱和量及麻醉效果。结果 32例中的10例手术在15分钟内完成。另22例手术时间超过15分钟(多为双眼手术)者,追加氯胺酮静脉麻醉者1次16例,2次6例,32例52眼麻醉效果满意,均顺利完成手术。结论 幼儿白内障手术表面麻醉,球后麻醉联合氯胺酮麻醉效果满意,由于减少氯胺酮用量,对幼儿更加安全。  相似文献   

5.
目的探讨采取综合措施对84例闭角型青光眼在高眼压状态下进行手术的效果。方法(1)眼压3.86~4.6kPa者采用球后麻醉或球周麻醉,间断加压控摩10分钟.术中角巩膜切口时先作小切口,缓慢放出房水,待眼压降低后按拟定手术方式完成手术。(2)眼压>4.6~6.62kPa者采用人工冬眠加上述方式。(3)眼压>6.62kPa者用人工冬眠加球周麻醉及按摩加压和后巩膜穿刺术降低眼压完成手术。结果眼压控制满意,术后视力较术前提高,并发症与一般青光眼手术无明显差异。结论高眼压状态下采取综合措施进行手术安全、简便、可靠。  相似文献   

6.
目的探讨手法小切口白内障摘出人工晶状体植入术的手术要点及临床效果。方法对1013例(1290眼)手法小切口非超声乳化无缝线门内障摘出人工晶状体植入术,采用手法注水娩核法。结果(1)1080眼采用表面麻醉,占83.72%;26眼为表面麻醉联合球结膜浸润麻醉,占2.02%;184眼为表面麻醉联合球周麻醉,占14.26%.(2)1215眼手术过程顺利,人工晶状体准确囊袋内植入,占94.19%;75眼后囊破裂,处理玻璃体后人工晶状体植入睫状沟(其中13眼行单襻或双襻缝线固定术),占5.81%。(3)术后89眼切口缝合1~3针,占6.90%。(4)视力≤0.3者87眼,占6.74%;≥0.5者1222眼,占94.73%;≥1.0者557眼,占43.18%。结论小切口非超声乳化无缝线自内障摘出人工晶状体植入术是具有良好临床效果的现代白内障摘出术式之一;灵活的麻醉方式,自闭式隧道切口,大直径撕/截除前囊及注水式娩核是手术要点;在基层医院及经济欠发达地区具有重要的防盲治盲作用及意义。  相似文献   

7.
目的 探讨表面麻醉联合结膜下麻醉在手法小切口超硬核白内障手术中应用的可行性,并对其效果进行评价。方法 对258例(295眼)不宜行超声乳化的超硬核白内障在表面麻醉联合结膜下麻醉的情况下行小切口白内障囊外摘出联合人工晶状体植入术。观察麻醉效果及术中术后并发症。结果 258例(295眼)手术麻醉效果成功率达100%,术中均未出现常规麻醉可能导致的局部及全身并发症。结论 表麻联合结膜下麻醉在手法小切口超硬核白内障手术中麻醉效果良好,安全性高。  相似文献   

8.
目的:评价表面麻醉小切口白内障囊外摘除联合人工晶体植入术在高原地区大规模白内障防盲手术中应用的有效性和安全性。方法四川省高原地区贫困白内障防盲手术患者457例(457眼),在表面麻醉下行小切口白内障囊外摘除联合人工晶状体植入术,观察其麻醉效果、手术并发症及术后视力。结果所有患者均在表面麻醉下完成手术,均无严重的手术并发症。术后第1天,视力≥0.3者384眼,占84.03%。结论在高原地区大规模白内障防盲手术中应用表面麻醉小切口白内障囊外摘除联合人工晶体植入术安全、有效。  相似文献   

9.
表面麻醉加球结膜下麻醉在白内障手术应用   总被引:2,自引:3,他引:2  
目的探讨球结膜下麻醉行白内障手术治疗的可行性并对其效果进行评价。方法对512例(578眼)白内障在表面麻醉联合球结膜下麻醉情况下,分别行晶状体超声乳化人工晶状体植入术338例(386眼)及小切口白内障囊外摘出,人工晶状体植入术174例(192眼)。观察麻醉效果及术中术后并发症。结果578眼麻醉成功率100.00%,术中未出现常规麻醉可能出现的局部及全身并发症。结论表面麻醉联合球结膜下麻醉行白内障手术麻醉效果好,安全性高,适应证范围广。  相似文献   

10.
青光眼合并白内障的手术选择   总被引:1,自引:1,他引:1  
目的探讨原发性闭角型青光眼合并白内障的手术选择。方法38例(40眼)原发性闭角型青光眼合并白内障,根据眼压是否易被控制及C值等分别采用不同的手术方式,其中施行晶状体超声乳化人工晶状体植入术25例(27眼);白内障青光眼联合手术10例(10眼);分期手术(先行青光眼手术,再行白内障手术)3例(3眼)。术后随访1~12月。结果术后视力均有不同程度提高。单纯白内障组中,24眼眼压控制正常,3眼需在药物治疗下控制正常。10眼联合手术和3眼分次手术眼压均控制正常。角膜水肿5眼,其中单纯白内障组者3眼(11.11%),联合手术组者2眼(20.00%)。术后前房纤维素性渗出2眼均为联合手术组者。结论青光眼合并白内障应根据各项检查结果选择适当的手术方式,才能降低眼压,提高视力,减少术后并发症的发生。  相似文献   

11.
Clinical data of 69 patients due to undergo ECCE with PCIOL implantation were evaluated in a standardized fashion. The preliminary results show that the blood pressure measured preoperatively and intraoperatively necessitated antihypertensive therapy. The averaged systolic blood pressure in the ward was 147.2 +/- 20.4 mm Hg; before retrobulbar anesthesia 159.9 +/- 30.4 mm Hg; after retrobulbar anesthesia 172.6 +/- 24.2 mm Hg; and at the start of surgery 154.2 +/- 18.4 mm Hg. Maximum intraoperative blood pressure was 156.2 +/- 20.7 mm Hg; at the end of surgery it was 144.3 +/- 19.5 mm Hg. In 12 patients (17%), systolic blood pressure higher than 200 mm Hg was measured after retrobulbar anesthesia. Antihypertensive therapy (nifedipine, nitroglycerin) was initiated in 44 patients (64%). These data support the recommendation that blood pressure should be monitored continuously both before and during the operation in order to minimize the rate of surgical and general complications.  相似文献   

12.
目的 通过对正常血压和合并高血压的两组老年性白内障患者超声乳化术中血压及心率变化曲线哌的分析,评价该手术对心血管系统的影响.方法 对伴有高血压的老年性白内障患者46例、正常血压白内障患者44例在心电监护仪监测下进行超声乳化白内障摘除联合人工晶状体植入术,观察术前及术中不同时间血压及心率的变化.结果 两组患者在进入手术室后血压与病区血压比较均有显著差异,高血压组在手术开始和术中10 min血压及心率的变化曲线呈现明显升高然后回落的变化.结论 手术相关刺激引起的应激反应在高血压组可以出现神经性血压升高,高血压患者手术中实施心电监护是十分必要的.  相似文献   

13.
王丽  王晓霞  林娜 《国际眼科杂志》2016,16(11):2139-2141
目的:评估球筋膜下麻醉在高眼压下复合式小梁切除术中的有效性与安全性。
  方法:选取2014-02/2015-06在我科住院后联合用药24~48 h眼压控制不良的原发性青光眼患者46例46眼,于球筋膜麻醉下行复合式小梁切除术,观察麻醉效果及并发症。
  结果:所有患者注射麻药后1 min均能达到镇痛、眼球制动效果。手术过程中,0级麻醉效果35眼(76%),1级麻醉效果10眼(22%),2级麻醉效果1眼(2%)。除1例1眼患者术中需追加1次表麻剂后完成手术,其余患者均能在球筋膜麻醉下配合手术,麻醉总有效率为98%。术中术后无1例出现麻醉相关并发症。
  结论:高眼压下复合式小梁切除术中应用球筋膜下麻醉安全有效、简便快捷。  相似文献   

14.
Recently general anesthesia has become more popular than local for dacryocystorhinostomy, but the increasing bleeding tendency has hindered precise suturing of the nasal and lacrimal flaps. This paper describes a method of achieving controlled sedation with meperidine and chlorpromazine, postural sphenopalatine block with a mixture of cocaine and epinephrine, and nasociliary block with lidocaine. The dry field permits precise suturing of the mucosal flaps and has enabled the authors to gain experience with the miniature aneurysm needle of Reverdin, which facilitates suturing, and with Guibor's canaliculus intubation set, which is especially useful when flap suturing is not possible. Of 20 patients in whom this method was used, 16 obtained relief from dacryocystitis or tearing. Retrobulbar hemorrhage occurred in one patient during induction of the nasociliary block, necessitating cancellation of the operation, and pneumonitis occurred postoperatively in another patient. Respiratory gas exchange was normal when tested. The controlled sedation induced a fall in blood pressure and a rise in heart rate. No adverse effects of any of the drugs were noted. Thus, this method of controlled sedation and regional anesthesia is safe and effective, and because it reduces the bleeding tendency it makes the operation easier and shorter.  相似文献   

15.
高翔  秦学斌  郭军 《国际眼科杂志》2011,11(8):1466-1468
目的:观察不同麻醉方法下视网膜脱离外路手术中的眼心反射。方法:选取我科2008-06/2010-03住院患者109例109眼,随机分为对照组和治疗组,分别采用球后阻滞麻醉与静脉复合麻醉进行视网膜脱离外路手术,观察术中血压、心率、眼心反射、血氧饱和度等情况。结果:与球后阻滞麻醉比较,静脉复合麻醉下眼心反射发生率低,收缩压、舒张压及平均血氧饱和度变化较小,经统计学处理,差异有统计学意义(P<0.01)。结论:静脉复合麻醉下行视网膜脱离外路手术相对安全,并发症少,效果满意。  相似文献   

16.
BACKGROUND AND OBJECTIVE: To evaluate the adequacy of retrobulbar block anesthesia only in vitreoretinal surgery. PATIENTS AND METHODS: The study involved 90 patients, 25 who underwent 25-gauge transconjunctival sutureless vitrectomy and 65 who underwent 20-gauge standard pars plana vitrectomy. Twenty-five of the 90 patients also underwent combined phacoemulsification and posterior intraocular lens implantation. The efficacy of retrobulbar block anesthesia only was assessed by monitoring vital signs during surgery, reviewing patient responses to a questionnaire regarding their experience during surgery, and analyzing surgical outcomes. RESULTS: Four patients complained of moderate pain during surgery, but no patient complained of severe pain. Infiltrative anesthesia was additionally required in 14 patients. No patient experienced intraoperative complications due to head movement. Increased systolic blood pressure greater than 15 mm Hg occurred in 11 patients and increased respiratory rate by 3 breaths per minute or greater occurred in 7 patients. Anatomical and functional success rates were 95% and 80%, respectively. Complications included manageable retrobulbar bleeding (1 patient) and postoperative neovascular glaucoma (2 patients). CONCLUSION: Vitreoretinal surgery, particularly 25-gauge transconjunctival sutureless vitrectomy, can be safely and efficiently performed under retrobulbar block anesthesia only. Retrobulbar block anesthesia only could become a more acceptable anesthesia for vitreoretinal surgery for selected patients.  相似文献   

17.
目的:评价单用布比卡因注射液的免置管浸润麻醉在玻璃体视网膜手术中的临床效果.方法:选取在我院进行玻璃体视网膜手术的患者58例58眼,随机分为两组,观察组(28例28眼)采用单用布比卡因注射液的免置管浸润麻醉,对照组(30例30眼)采用传统Tenon囊下麻醉.运用NRS-11(the 11-point numeric rating scale,NRS-11)监测患者麻醉过程、巩膜切口、眼内操作过程中及手术结束时疼痛程度的情况,并记录两组患者心率、血压变化以及麻醉时间.结果:两组患者麻醉过程、巩膜切口、眼内操作过程中及手术结束时NRS-11评分差异均无统计学意义(P>0.05);患者心率、血压变化差异亦均无统计学意义(P>0.05);两组麻醉时间比较差异有统计学意义(P<0.05).结论:单用布比卡因注射液可取得与利多卡因、布比卡因混合液相同的效果,免置管浸润麻醉耗时短,是一种安全、有效的麻醉方法.  相似文献   

18.
PURPOSE: The effects of extraconal, peribulbar anesthesia on ocular blood flow may be caused by concomitant elevations in intraocular pressure or direct pharmacologic alteration of vascular tone. We quantified the effect on ocular circulation with a new technique for assessment of ocular hemodynamics. METHODS: In a prospective study, ocular hemodynamics were measured before and 1 and 5 minutes after peribulbar anesthesia in 22 eyes with age-related cataract. Measurements included fundus pulsation amplitude with a laser interferometric method assessing the pulsatile choroidal blood flow and mean blood flow velocity as well as resistive index in the ophthalmic and central retinal artery with Doppler sonography. Systemic blood pressure and pulse were monitored throughout the period of ocular hemodynamic measurements. RESULTS: Fundus pulsation amplitude decreased significantly after peribulbar anesthesia (after 1 minute and 5 minutes: -13% and -8%; P < .001). In the central retinal artery, mean blood flow velocity dropped (-15%; P < .001) and resistive index increased (+3%; P = .02) 1 minute after peribulbar anesthesia compared with baseline. There were no changes in ophthalmic artery hemodynamics. Intraocular pressure was elevated 1 minute after peribulbar anesthesia (+29%; P = .003) but reached baseline values after 5 minutes. CONCLUSION: Pulsatile choroidal blood flow and retinal blood flow velocities were reduced after peribulbar anesthesia. These reductions were still present 5 minutes after peribulbar anesthesia, when intraocular pressure had returned to baseline values. This supports the theory of drug-induced vasoconstriction after peribulbar anesthesia. A loss of vision may be a risk of peribulbar anesthesia in patients who have compromised ocular blood flow before surgery.  相似文献   

19.
An attempt of sedative procedures associated with a locoregional anesthesia was performed on fifty old patients before cataract operation. The blood gases, the blood pressure and the heartrate were measured and the behaviour of the patient just before he awoke was examined to determinate the sedative value. A parallel study revealed a decrease of the intra ocular pressure of 2,5 mm d'Hg due to a slight decrease of the blood pressure and to the effect of the neurolep mixture: the Innovar. This method seems to be very satisfactory in Ophthalmology.  相似文献   

20.
目的:探讨丙泊酚复合小剂量氯胺酮在小儿眼科手术中的应用价值。方法选取66例ASA I~II级择期实施小儿眼科手术的病人,随机分成研究组(33例)和对照组(33例),研究组运用丙泊酚复合小剂量氯胺酮进行麻醉,对照组采用氯胺酮进行麻醉。比较两组患者各个时间点的心率、平均动脉压、眼内压。药物停止以后分别记录两组患者的完全清醒时间以及评估术后恶心、呕吐等方面的情况。结果对照组患者在气管插管时、手术开始时、术中第15 min及手术结束时的心率、平均动脉压与麻醉前相比均有增快和升高(P<0.05)。两组患者的相应各时点参数相比较均有极显著性差异(P<0.05);对照组患者气管插管时、手术开始时的眼内压跟麻醉前相比均有升高(P<0.05),两组相应时点的眼内压相比较均有显著差异(P<0.05)。研究组的恶性呕吐发生率明显低于对照组(P<O.05),清醒时间也明显短于对照组(P<;0.05)。结论丙泊酚复合小剂量氯胺酮用于小儿眼科手术的应用价值比较高,围术期的血流动力学稳定性好,术后恶心呕吐发生率低。  相似文献   

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