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限制性流体与自由流体协议对容易发生脊椎手术的患者眼睛参数的影响:随机对照试验

Xiao-Yu Yang¹, Miao-Miao Wei¹, Hong Tan¹

¹Department of, Anaesthesiology, Huashan Hospital Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, China.

Perioperative medicine (London, England)

|June 12, 2023

概括

与限制性协议相比,在倾斜的脊柱手术期间,自由流体协议显著增加了眼内压力 (IOP). 然而,视神经外直径 (ONSD) 没有受到任何流体管理策略的显著影响.

科学领域:

麻醉学麻醉学
眼科医生眼科眼科
神经外科神经外科

背景情况:

在容易手术期间,眼内压力升高 (IOP) 和视神经胀可能导致眼睛和视神经缺血.
流体管理策略可能会影响易受手术的患者的内腔透视率和视神经外直径 (ONSD).

研究的目的:

调查自由与限制性流体协议对易经脊椎手术的患者的IOP和ONSD的影响.
为了确定自由流体协议是否与限制性协议相比,加剧了IOP和ONSD.

主要方法:

一项前性随机试验,涉及97名接受脊柱倾向性手术的患者.
患者被分配到自由液体输液组 (维持6-9%的脉压变化[PPV]) 或限制性组 (PPV13-16%).
在多个时间点测量IOP和ONSD,包括卧卧,俯卧位置和术后.

主要成果:

两组均从基线显著增加了内血压,在自由流体组观察到的增加更大 (p=0.019).
视神经外直径 (ONSD) 与基线相比在两组中都显著增加,自由和限制性流体协议之间没有统计学上显著的差异 (p>0.05).
与限制性协议相比,自由流体协议导致了更高的最终IOP.

结论:

一个自由流体的协议增加眼内压力 (IOP) 在容易脊椎手术的患者.
流体管理策略在这个患者群体中没有显著影响视神经外直径 (ONSD).
这些发现表明,虽然自由的液体管理可以提高内压,但在倾向性脊柱手术期间,它可能不会在ONSD方面对视神经构成额外的风险.

关键词:

流体疗法是一种流体疗法.眼内压力眼内压力眼神经的视觉神经是什么术后并发症术后并发症在俯卧的位置.

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