目的：分析全身麻醉在青光眼日间手术中的应用特点。方法：回顾性收集2023年1月—6月于中山大学中山眼科中心在全身麻醉下接受青光眼日间手术患者71例(全麻组)，并选择同时期在局部麻醉下接受青光眼手术患者154例(局麻组)，同时以年龄为配对因素行倾向评分匹配分析。主要观察指标为患者术后离院时间，并对患者的手术时间、手术前后眼压、视力、中央前房深度、周边前房深度、甘露醇使用情况以及术后较术前眼压降低差值进行分析。结果：与局麻组比较，全麻组患者术后离院时间未有延长(P>0.05)；全麻组患者术前眼压较高(P<0.001)、中央前房深度浅(P=0.018)、周边前房深度浅(P<0.001)；且全麻组患者在术后较术前眼压降低差值更大(P=0.002)。组间术后中央前房深度、术后使用甘露醇者比例及术后视力提高者比例比较差异均无统计学意义(P>0.05)。结论：术前眼部条件较差的青光眼患者能在全身麻醉下完成日间手术，且不延长术后离院时间。

Objective: To analyze the application of general anesthesia in the ambulatory glaucoma surgery. Methods: This retrospective study collected 71 patients who underwent ambulatory glaucoma surgery with general anesthesia at Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2023 to June 2023, and 154 patients who underwent similar glaucoma surgery with local anesthesia during the same period. Age differences between the two groups were balanced by propensity score-matched analysis. The main outcome measures were the patients' post-operative discharge time, and the secondary end points included the duration of surgery, the patients' preoperative and postoperative intraocular pressure (IOP), visual acuity status, central anterior chamber depth, peripheral anterior chamber depth, mannitol use, the difference in IOP reduction after surgery compared to preoperative. Results: After propensity score-matched analysis, as compared with group L, general anesthesia did not prolong the patients' post-operative discharge time(P>0.05).Patients in the group G displayed significant higher IOP (P<0.001), shallower central anterior chamber depth (P=0.018), and shallower peripheral anterior depth (P<0.001). The dramatic reductions in IOP after surgery were exhibited in group G as compared with group L(P=0.002). There were no statistically significant differences in postoperative central anterior chamber depth, incidences in postoperative mannitol use, as well as incidences in visual acuity improvement on the first day after surgery. Conclusion: Glaucoma patients with poor preoperative ocular conditions were able to complete the complex glaucoma surgery under general anesthesia without prolonging their post-operative discharge time.

目的：总结全身麻醉斜视矫正日间手术服务模式的创建与安全管理方法。方法：回顾2015年10月至2018年10月期间全身麻醉下行斜视矫正日间手术患者共9 570例。改革护理管理模式，实施医护一体化，在实施过程中对患者进行严密的术前、术后护理管理：术前评估，健康教育前移、加强核查制度、严格监测患者生命体征；术后病情严格交接，家属及患者同步术后指导、离院后回访。结果：全身麻醉斜视矫正日间手术的9 570例患者，均未发生手术并发症，术后不适34例，占0.36%，其中2例患者离院时出现头晕，2例发生尿储留，30例出现恶心、呕吐。护理人力由开展前16人减少到12人，节约25%；患者等候手术时间缩短了8 d，满意度由70%提高到90%，平均住院时间由3.2 d减少为1 d。结论：全身麻醉斜视矫正日间手术模式是一种新的医疗模式，开展全身麻醉日间手术不但可以节省医疗资源，还可提高患者满意度。

Objective: To summarize the establishment and safety management methods of ambulatory strabismus surgery that can provide the basis for carrying out ambulatory surgery nursing under general anesthesia. Methods: We carried out ambulatory surgery management that reformed nursing management model and delivered the integration of medical care in 9 570 patients undergoing strabismus surgery under general anesthesia from October 2015 to October 2018. In implementation process, we carefully managed the patients before and after operation including performing preoperative assessment and health education in advance, strengthening the verification system, strictly monitoring vital signs of the patients, strict shifting state of patients after operation, providing postoperative guidance to patients and their families, and performing follow-up clinic visits after leaving the hospital. Results: No surgical complications occurred in any of our cases. 34 patients had postoperative discomfort, accounting for 0.36%. Among these 34 patients, 2 had dizziness, 2 had urinary retention and 30 had

nausea and vomiting. After treatments, all patients were discharged on schedule. The number of nurses reduced from 16 to 12 that fell by 25%. Wait times for operation reduced by 8 days. Patient satisfaction was improved from 70% to 90%. The mean length of hospital stay was reduced from 3 days to 1 day. Conclusion: The management of ambulatory surgery under general anesthesia is a new medical care service model. Careful planning and strict preoperative and postoperative safety management can ensure the safe implementation of strabismus surgery. Ambulatory surgery under general anesthesia has benefits to save medical resources and improve patient satisfaction.

目的：评价丙泊酚-阿芬太尼-利多卡因混合剂在成人白内障日间手术中的麻醉镇静效果与不良反应。方法：回顾性分析2021年1月至2021年6月中山大学中山眼科中心接受丙泊酚-阿芬太尼-利多卡因静脉镇静下白内障日间手术的患者(静脉镇静组，n=30)，并匹配同一主刀医师、诊断相似且在丙美卡因表面麻醉下白内障手术患者(表麻组，n=30)。比较两组患者围手术期血流动力学变化、手术中眼位评级、手术中断的次数、手术时间、手术后苏醒时间、出院时间、术中手术体验以及术后不良事件等指标。结果：所有患者均在原麻醉方式下顺利完成手术；与表麻组相比，静脉镇静组手术中断次数显著降低(P<0.05)，围手术期血压更平稳，且术后满意度评价明显升高(P<0.05)。结论：丙泊酚-阿芬太尼-利多卡因静脉镇静能显著提升白内障日间手术患者的就医体验，而不影响手术进程。

Objective: The aim of this study is to observe the efficacy and safety of propofol-alfentanil-lidocaine mixture in adult patients for cataract ambulatory surgery. Methods: Thirty adult patients undergoing cataract ambulatory surgery sedated by propofol-alfentanil-lidocaine mixture from January 2021 to June 2021 were enrolled in this retrospective study (sedation group, n=30). Meanwhile, another thirty patients with similar diagnosis performed by the same surgeons under topical anesthesia were matched in this study (topical anesthesia group, n=30). The scores of intraoperative eye position, the number of surgical interruptions due to poor cooperation, surgical time, emergence time, time to discharge, changes in blood pressure, surgical experience, as well as any adverse events were compared between the two groups. Results: The surgeries were successfully completed in all patients in both groups. Compared to topical anesthesia group, patients under sedation showed less surgical interruptions and more stable hemodynamics during the surgery, as well as better surgical experience (all P<0.05). Conclusion: Sedation with propofol-alfentanil-lidocaine mixture can significantly improve the surgical experience of patients undergoing cataract ambulatory surgery without prolonging duration of the surgery.