Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA.
Retina. 2012 Jul;32(7):1324-7. doi: 10.1097/IAE.0b013e31823bea54.
To assess whether snoring is associated with sudden patient movement during local anesthesia with intravenous sedation.
In this prospective cohort study, patients undergoing ocular surgery with local anesthesia with intravenous sedation were studied. The occurrence or absence of snoring, and whether patient movement was noted were prospectively recorded. Complications that arose from patient movement were also noted.
A total of 230 surgical procedures were included in the study. All cases were vitreoretinal surgery cases. During 37 procedures, snoring was noted, and among these, 18 patients (48.6%) moved their head suddenly. In contrast, movement occurred during only 2 of 193 procedures (1.0%) without documented snoring (P < 0.001). Thus, sudden patient head movement was approximately 49 times more prevalent in patients who snored. Continuous infusion propofol was also associated with sudden unexpected head movement (P = 0.0028). No complications as a result of the movement were identified in this study.
Snoring during local anesthesia with intravenous sedation predicts a high likelihood of sudden patient movement during local anesthesia with intravenous sedation. The use of continuous infusion propofol anesthetic may increase the chance of head movement. Eye surgeons should be aware of these associations to help minimize the risk of complications caused by patient movement.
评估在静脉镇静局部麻醉期间患者是否因打鼾而突然移动。
在这项前瞻性队列研究中,研究了接受静脉镇静局部麻醉的眼科手术患者。前瞻性记录打鼾的发生或不发生,以及是否注意到患者移动。还记录了因患者移动而引起的并发症。
共有 230 例手术纳入研究。所有病例均为玻璃体视网膜手术病例。在 37 例手术中,有打鼾,其中 18 例(48.6%)患者头部突然移动。相比之下,在没有记录到打鼾的 193 例手术中,仅 2 例(1.0%)发生了移动(P<0.001)。因此,打鼾患者头部突然移动的可能性大约是无打鼾患者的 49 倍。连续输注丙泊酚也与突然出现的意外头部运动有关(P=0.0028)。本研究未发现因运动引起的并发症。
静脉镇静局部麻醉期间的打鼾预示着静脉镇静局部麻醉期间患者突然移动的可能性很高。使用连续输注丙泊酚麻醉可能会增加头部运动的机会。眼科医生应该意识到这些关联,以帮助最大程度地降低因患者移动引起的并发症风险。