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没有静脉麻醉的帕斯普拉纳玻璃切除术:技术,安全性和结果

Karena X Tien¹, Erica Romo¹, Murtaza K Adam²

¹Rocky Vista University, Parker, CO, USA.

Journal of vitreoretinal diseases

|October 2, 2024

概括

帕斯普拉纳视切除术 (PPV) 可以在没有静脉麻醉的情况下安全地进行,只使用局部麻醉和口服镇静. 这种方法显示出良好的结果和高的患者满意度重复手术.

科学领域:

眼科医生眼科眼科
视网膜外科手术视网膜外科手术
在眼科手术中麻醉.

背景情况:

静脉内 (IV) 麻醉通常用于帕斯普拉纳视切除术 (PPV).
替代性麻醉技术可以改善患者的舒适性并降低风险.
没有静脉麻醉的PPV的安全性和有效性需要进一步研究.

研究的目的:

评估不使用静脉麻醉进行PPV的技术,安全性和结果.
评估使用局部麻醉与口服镇静治疗PPV的可行性.
将结果与历史数据或标准IV麻醉方案进行比较.

主要方法:

在2018年9月至2022年4月期间对319名患者进行的357个PPV的回顾性研究.
患者要么没有接受镇静剂,要么接受口服镇静剂 (舌下三胺) 与Sub-Tenon布皮瓦卡因和利多卡因相结合.
由循环护士进行手术期间的监测;记录了不良事件,视力敏度和重新手术率.

主要成果:

没有观察到手术内并发症,全身不良事件或需要转换为IV镇静剂.
手术后视力敏度显著改善,从0.68 ± 0.77升至0.31 ± 0.46 logMAR (P < .01).视力敏度显著改善,从0.68 ± 0.77升至0.31 ± 0.46 logMAR (P < .01).
95%的接受重新手术或同眼手术的患者要求使用相同的麻醉方法.

结论:

在没有麻醉师支持的情况下,可以安全地使用Sub-Tenon阻塞和口服镇静进行Pars plana玻璃切除术.
这种麻醉方法耐受性很好,并与良好的视觉结果有关.
建议进行进一步的研究,以量化患者的舒适度和外科医生的经验.

关键词:

风险管理风险管理外科手术技术和操作方法玻璃甲状腺外科手术是什么?

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