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滑车下神经阻滞降低斜视手术患儿术后恶心呕吐的发生率——一项回顾性研究

The Infratrochlear Nerve Block Reduces the Incidence of Postoperative Nausea Vomiting in Pediatric Patients Undergoing Strabismus Surgery-A Retrospective Study.

作者信息

Oh Chung-Sik, Shin Hyun Jin, Park Seon-Ju, Kim Seong-Hyop, Lee Yea-Ji

机构信息

Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Seoul 05030, Republic of Korea.

Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05030, Republic of Korea.

出版信息

Biomedicines. 2025 Feb 25;13(3):580. doi: 10.3390/biomedicines13030580.

Abstract

: Strabismus surgery in pediatric patients is associated with a high incidence of postoperative nausea and vomiting (PONV). Patients showing pain are more prone to develop PONV. As the infratrochlear nerve (ITN) block can ameliorate perioperative pain following strabismus surgery, we hypothesized that ITN block may influence PONV in pediatric patients undergoing strabismus surgery. : The medical charts of pediatric patients older than 2 years with exotropia who underwent strabismus surgery under general anesthesia, with or without ITN block, were reviewed retrospectively. The incidence of PONV, intraoperative surgical pleth index (SPI), state entropy (SE), response entropy (RE), the changes in hemodynamics, and perioperative use of metoclopramide and ketoprofen were investigated. : The study population comprised 116 patients (58 for the No-block group vs. 58 for the ITN group). The incidence of PONV was significantly lower in the ITN block group compared to the No-block group (5.2% vs. 22.4%, respectively; = 0.015). The SPI at conjunctiva incision, muscle dissection and traction were significantly lower in the ITN block group than in the No-block group. SE was comparable between the two groups, but RE at muscle dissection and traction was significantly lower in the ITN block group than in the No-block group. The use of metoclopramide and ketoprofen was also lower in the ITN block group than in the No-block group. : ITN block reduced PONV as well as perioperative pain in pediatric patients undergoing strabismus surgery.

摘要

小儿斜视手术术后恶心呕吐(PONV)的发生率较高。有疼痛表现的患者更易发生PONV。由于滑车下神经(ITN)阻滞可减轻斜视手术后的围手术期疼痛,我们推测ITN阻滞可能会影响接受斜视手术的小儿患者的PONV。

回顾性分析了年龄大于2岁、接受全身麻醉下斜视手术(无论是否行ITN阻滞)的外斜视小儿患者的病历。调查了PONV的发生率、术中手术容积指数(SPI)、状态熵(SE)、反应熵(RE)、血流动力学变化以及围手术期胃复安和酮洛芬的使用情况。

研究人群包括116例患者(无阻滞组58例,ITN组58例)。与无阻滞组相比,ITN阻滞组的PONV发生率显著更低(分别为5.2%和22.4%;P = 0.015)。在结膜切开、肌肉分离和牵拉时,ITN阻滞组的SPI显著低于无阻滞组。两组之间的SE相当,但在肌肉分离和牵拉时,ITN阻滞组的RE显著低于无阻滞组。ITN阻滞组胃复安和酮洛芬的使用量也低于无阻滞组。

ITN阻滞降低了接受斜视手术的小儿患者的PONV以及围手术期疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7511/11940196/961f843a40ea/biomedicines-13-00580-g001.jpg

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