Studies Of Children Strabismus Correction Surgery Anesthesia

Purpose1. Preliminary understand oculocardiac reflex(OCR) affect on blood sugar levels of 2~9 strabismus children under the general anesthesia, infer the rehydration types in children strabismus surgery. 2.Implement a clinical observation in intraoperative cooperative 10~14 years old children underwent strabismus diorthosis under local anesthesia compound midazolam sufentanil to provide a safe and comfortable anesthesia method, other than the general anesthesia, which could awake patients intraoperatively to test the correction effect to improve the success rate of the operationfor the children in this age paragraph.Content 1. Affection of OCR on 2~9 years old children’s blood sugar levels under general anesthesia strabismus diorthosis. 2.Effect of local anesthesia compound midazolam sufentanil in 10~14 years old children strabismus surgery.Methods1. 1.Select 100 children 2~9 years old, ASA I level, tend to operate strabismus diorthosis under general anesthesia, gender not limited. Conventional surveillance after entering room, and intravenous-inhalation induction of general anesthesia, laryngeal mask airway. Inhalate low concentration sevoflurane intraoperatively to maintain appropriate anesthesia depth, retain spontaneous breathing,rehydration use 0.9% sodium chloride injection. Before using eye speculum,take the determination of blood glucose value between general anesthesia induction and OCR occurred. During the operation, start timing as OCR occurred,determine the blood glucose values at time point 2 min, 5 min, 10 min respectively after the reflection,compare and analysis data of two adjacent time points, to determine the change trend of children’s blood glucose values after the OCR. 2. Select 70 strabismus patients,aged 10~14,ASA I level, randomly divided into I group: local anesthesia group; II group: local anesthesia compound midazolam sufentanil group. No medication before anesthesia. Entering room, routine surveillance, inhalate oxygen through nasal catheter and infuse sodium lactate ringer’s solution intravenously. I group drop surface anesthetics combined with 0.5% dicaine cotton ball tamponade under conjunctival. According to the requirements of patients or the change of monitoring indicators to add local anesthetics. II group intravenous midazolam 25 u g/kg,composite sufentanil 0.08 u g/kg for the first time, vein last 0.01 u g/(kg/min) on the basis of group I. When excessive sedation presence,as hypoxemia and apnea,appear intraoperatively, lift the chin and call him/her to make the patient restore.Respectively record the monitoring indicators after entering room, anesthesia, the beginning of surgery and 8min later and the end, intraoperative complications and operation time. Postoperative immediately evaluate patient’s pain level during the operation with visual analogue scale( VAS) and memory of operation process by another anesthesiologist not participate in this study.Results 1. From before the OCR to any two time points within 5 minutes after OCR,the difference of data comparison results had statistical significance, but the blood glucose value of 10 minutes and 5 minutes after reflection contrast difference is not significant. All the children did not appear low blood glucose.2.General condition and operation time had no statistically significant difference between two groups patients.From surgery start to finish, each monitoring index,intraoperative complications and VAS score of the group Ⅱ patients were significantly lower than Ⅰ group, the difference was statistically significant.Conclusion 1. After the OCR, rising trend of children blood glucose value can maintain about 10 minutes,which has nothing to do with gender factors. The child’s body quality factor may affect blood sugar change trend. 2. On the basis of good local anesthesia, reasonably using sedation analgesia drugs can make children aged 10 to 14 undergo strabismus diorthosis soothing calm, maintain satisfactory spontaneous breathing and to make the right response to the doctor instruction, to maintain the stability of hemodynamics, timely evaluate surgery effect, improve the success rate of surgery,but a few children suffered respiratory depression.