目的：分析喉罩在肥胖患者眼科日间手术中的应用特点。方法：选择 2021 年 1 月— 2024 年 3 月在中山大学中山眼科中心行日间眼科手术 且体质量指数（body mass index，BMI）≥25 kg/m²的男性患者进行分析，将患者分为2组：超重组（BMI 25~<30 kg/m2）及肥胖组（BMI≥30 kg/m²）。比较两组患者入室时（T₁）、诱导后（T₂）、喉罩置入后（T₃）、手术开始时（T₄）、手术开始10 min（T₅）、手术结束时（T₆）、入麻醉恢复室（post-anesthesia care unit，PACU）（T₇）、喉罩拔除时（T₈）的血流动力学和血氧饱和度变化情况；并分析喉罩置入后（T₃）、手术开始时（T₄）、手术开始10 min（T₅）、手术结束时（T₆）和喉罩拔除时（T₈）患者的呼吸参数变化情况，记录两组患者的喉罩通气成功率及复苏室的停留时间。结果：纳入 118 例患者，其中超重组 57 例、肥胖组 61 例。两组均未出现喉罩通气失败病例，肥胖组在T₃、T₄、T₅、T₆以及T₈等时点气道峰压均高于超重组（P < 0.05）；肥胖组的呼吸道不良事件发生率高于超重组（P < 0.05）。两组患者围术期生命体征平稳（P > 0.05），复苏室停留时间在组间比较差异无统计学意义（P > 0.05）且均顺利日间手术离院。结论：喉罩通气下全身麻醉能安全应用在肥胖患者眼科日间手术中，高BMI与高气道峰压相关。

Objective: General anesthesia using laryngeal mask airway (LMA) ventilation can facilitate ambulatory ophthalmic surgery, however, there remains debates about the use of LMA for obese patients. This study retrospectively analyzed the application of LMA in obese patients for ambulatory ophthalmic surgery. Methods: In this retrospective study, we analyzed all patients with a BMI≥25 kg/m2 who underwent ambulatory ophthalmic surgery under general anesthesia at the Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2021 to March 2024.  The patients were divided into two groups: overweight group (BMI 25~<30 kg/m2) and obese group (BMI ≥30 kg/m2) . We compared the changes in hemodynamics and oxygen saturation at the several time points, baseline after entering operating room (T₁), anesthesia induction (T₂), LMA insertion (T₃), start of surgery (T₄), 10 minutes after surgery (T₅), surgery completion (T₆), transfer to PACU (T₇), and LMA removal (T₈);and analyzed the changes in respiratory parameters of the patient at T₃, T₄, T₅, T₆, and T₈ time points between both groups. We also observed the differences in success rate of LMA insertion and ventilation and PACU stay time as well as time to discharge home between two groups. Results: 118 cases were found suitable for the final analysis and divided into overweight group (n=57) and obese group (n=61). All patients in the two groups uneventfully completed the ophthalmic ambulatory surgery and discharged home under the laryngeal mask airway ventilation, none of patients in both group displayed LMA ventilation failure. The hemodynamics and oxygen saturation in both groups were stable during perioperative period(P > 0.05). The peak airway pressures in obese group were dramatically increased than in overweight group at T₃, T₄, T₅, T₆ and T8 time points (P < 0.05), and the incidences of adverse respiratory events in obese group were significant higher than in overweight group （P < 0.05）. The PACU stay time was comparable in both groups (P > 0.05). Conclusion: LMA can be safely used for obese patients undergoing ophthalmic surgery, high BMI is related to high peak airway pressures.

目的：探究可弯曲喉罩在经鼻内镜眼科日间手术中应用的安全性。方法：收集2023年1月—2024年1月在全身麻醉(全麻)下行经鼻内镜眼科日间手术成年患者资料，分析可弯曲喉罩使用的成功率，观察患者入室时、插管后、手术开始时、手术结束时的血流动力学变化情况；并记录喉罩置入后、手术开始5 min、手术开始30 min和手术结束时的呼吸参数及患者在麻醉恢复室（post-anesthesia care unit，PACU的停留期间的并发症。结果：共635例患者纳入分析，其中619例患者选用喉罩，607例患者喉罩置入成功，成功率98.1%，喉罩置入失败12例，均为诱导期间置入失败，占1.9%，无术中发生喉罩通气失败改气管插管病例。喉罩通气能满足经鼻内镜手术需求，表现为各时点通气量无显著变化及平稳的心率和平均动脉压。患者均顺利复苏，PACU停留时间为(34.6±11.2) min，喉罩拔除时间为(14.3±4.3) min，无二次气管内插管事件发生。结论：置入成功的可弯曲喉罩可安全应用在经鼻内镜眼科日间全麻手术中。

Objective: To investigate the safety of flexible laryngeal masks in the application of endoscopic ophthalmic ambulatory surgery. Methods: Data of adult patients undergoing endoscopic day ophthalmic surgery under general anesthesia from January 2023 to January 2024 were collected; the changes in hemodynamics at T1 (entry into the operating room), T2 (after intubation), T3 (before surgery), and T6 (after surgery) time points and the respiratory parameters at T2 (after intubation), T4 (5 minutes after surgery), T5 (30 minutes after surgery), and T6 (after surgery) time points were analyzed; meanwhile, the complications during the PACU stay were also analyzed. Results: A total of 635 patients were included in the retrospective analysis, of whom 619 patients were initially used FLMA, FLMA were successfully inserted in 607 patients with a rate of 98.1% while 12 patients suffered insertion failure during the period of anesthesia induction. Importantly, none of patients displayed FLMA ventilation failure and required tracheal intubation during the period of surgery. General anesthesia via FLMA ventilation can provide high quality of surgical field for endoscopic ophthalmic surgery, as evidenced by stable heart rates and mean arterial pressure and no significant change in minute ventilation at each time points. All patients recovered uneventfully with a PACU stay time of 34.6±11.2 min and FLMA removal time of (14.3±4.3) min. None of patients exhibited subsequently endotracheal intubation after FLMA removal. Conclusion: FLMA with successful placement can be safely used for endoscopic ophthalmic ambulatory surgery under general anesthesia.

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