论著

24 180 例喉罩全身麻醉下接受眼科手术患儿麻醉复苏期的护理体会

Nursing experience of 24,180 children undergoing ophthalmic surgery under general anesthesia with laryngeal mask during anesthesia recovery period

:554-562
 
目的:探讨提高眼科喉罩全身麻醉患儿在麻醉后恢复室(postanesthesia care unit, PACU)复苏质量与效率的整体护理策略。方法:选取2020年1月—2023年12月在中山大学中山眼科中心行眼科全身麻醉并保留喉罩进入PACU复苏的24 180例小儿患者,总结患儿在PACU复苏的护理措施及复苏质量。结果:所有患儿经复苏期综合护理后均顺利拔除喉罩完成麻醉复苏,未发生苏醒期二次插管或非计划转院治疗。采取个性化的整体护理策略后,喉罩全身麻醉患儿PACU平均复苏时间明显缩短。部分术后常见并发症(术后躁动,低氧血症和呼吸道梗阻)和护理不良事件(留置针脱落和眼包脱落)发生率逐年降低,经治疗和护理后均获得改善。结论:针对眼科全身麻醉的患儿特点,在麻醉复苏期采取个性化的整体护理策略,有利于顺利完成麻醉复苏,降低麻醉并发症和护理不良事件的发生率,提高复苏质量效率,满足眼科日间手术快速康复的需求。
Objective: Exploring holistic nursing strategies to improve the quality and efficiency of postanesthesia care unit (PACU) resuscitation in childrenpatients undergoing ophthalmic laryngeal mask anesthesia. methods: Selecting a total of 24,180 children patients who underwent general anesthesia and retained laryngeal mask airway for PACU resuscitation at Sun Yat-sen Ophthalmic Center of Sun Yat sen University from January 2020 to December 2023, this study reviews and summarizes the nursing measures and resuscitation quality of children patients undergoing PACU resuscitation. Results: All patients underwent comprehensive care during the recovery period and successfully removed the laryngeal mask to complete anesthesia recovery. There were no cases of secondary intubation or unplanned transfer for treatment during the recovery period. After adopting personalized holistic nursing strategies, the average recovery time of PACU in children under laryngeal mask anesthesia was significantly shortened.The incidence of common postoperative complications(postoperative agitation, hypoxemia and respiratory obstruction)and adverse nursing events (indwelling needle falls off, eye bandage fall off)have been decreasing year by year. These complications have been improved after treatment and care. Conclusions: Based on the characteristics of children patients undergoing general anesthesia in ophthalmology, adopting personalized holistic nursing strategies during the anesthesia recovery period is beneficial for successfully completing anesthesia recovery, reducing the incidence of anesthesia complications and adverse nursing events, improving the quality and efficiency of recovery, and meeting the needs of rapid recovery in ophthalmic day surgery.
论著

喉罩复合七氟醚麻醉在小儿门诊全身麻醉眼底荧光素造影检查中的应用

Application of inhaled sevoflurane via laryngeal mask airway in children undergoing outpatient fundus fluorescein angiography with general anesthesia

:695-699
 
目的:观察喉罩通气吸入七氟醚麻醉在小儿眼底荧光素造影检查(fundus fluorescein angiography,FFA)期间眼位情况、眼球运动的发生率和丙泊酚调整眼位的有效率。方法:回顾性分析2018年6月至2019年12月七氟醚麻醉下接受FFA的儿童的病例资料,记录检查开始时眼位分级、检查中眼球运动发生率、丙泊酚调整眼位的有效率、麻醉后恢复自主活动时间以及不良事件。结果:纳入1~9岁患儿54例,检查开始时42.6%(23/54)的患者眼位1级,51.9%(28/54)的患者眼位2级,5.6%(3/54)的患者眼位3级,检查中眼球运动发生率为61.1%(33/54)。13%(7/54)的患儿需丙泊酚干预,丙泊酚1 mg/kg纠正眼位的有效率为100%。患儿麻醉后恢复正常活动的平均时间为24.4 min,未发生不良事件。结论:喉罩复合七氟醚的麻醉可为门诊小儿眼底荧光造影提供相对满意的麻醉质量,患者在麻醉后可迅速恢复日常活动,丙泊酚可迅速纠正检查中眼位不正。
Objective: To observe the eye position, the incidence of eye movement and the efficacy of propofol on correcting eccentric eyeball position in children undergoing examination of outpatient fundus fluorescein angiography (FFA) with inhaled sevoflurane via laryngeal mask airway. Methods: Children undergoing FFA with sevoflurane anesthesia from June 2018 to December 2019 were retrospectively reviewed. Eye position at the beginning of examination, incidence of eye movement during examination, the efficiency of propofol on correcting eccentric eyeball position during procedure, the time to resume normal activities, and adverse events were recorded. Results: Fifty-four children aged 1–9 years were included in this study. The rates of eye position from grade one to grade three at the beginning of examination were 42.6% (23/54), 51.9% (28/54), and 5.6% (3/54), respectively. The incidence of eye movement during examination was 61.1% (33/54). 13% (7/54) of children with unsatisfactory eye-position needed intervention with propofol. The efficacy of propofol (1 mg/kg) in correcting eye position was 100%. The mean time to return normal activities was 24.4 min. There were no any adverse events during the peri-anesthetic period. Conclusion: Inhaled sevoflurane via LMA can provide appropriate anesthesia for outpatient FFA in children. Children can resume daily activities soon after anesthesia. Propofol can return the incorrect eye position during examination
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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