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麻醉与术后眼内炎的关系:一项回顾性研究。

Relationship between anesthesia and postoperative endophthalmitis: A retrospective study.

作者信息

Lai Hou-Chuan, Tseng Wei-Cheng, Pao Shu-I, Wong Chih-Shung, Huang Ren-Chih, Chan Wei-Hung, Wu Zhi-Fu

机构信息

Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China Department of Ophthalmology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan, Republic of China.

出版信息

Medicine (Baltimore). 2017 Mar;96(12):e6455. doi: 10.1097/MD.0000000000006455.

Abstract

Previous study showed that patients under general anesthesia (GA) had nasopharyngeal secretions on the face at the end of ocular surgery, especially in propofol-based total intravenous anesthesia (TIVA), it might induce postoperative endophthalmitis. Therefore, we conducted a retrospective study to compare the incidence of endophthalmitis after ocular surgery under topical, inhalation anesthesia, and propofol-based TIVA in our medical center from 2011 to 2015.A total of 21,032 patients were included, and we evaluated epidemiologic factors, systemic diseases, other ocular pathologic characteristics, complications during the surgery, technique of ocular surgery, method of antibiotic prophylaxis, vitreous culture, and vision outcome in these patients.Fifteen endophthalmitis cases among 21,032 operations reported, equaling an incidence of 0.071%. The incidence rates under topical, inhalation anesthesia, and propofol-based TIVA were 0.083%, 0.039%, and 0%, respectively (P = 0.39). Moreover, the risk of endophthalmitis under GA (0.024%) was significantly lower than topical anesthesia (0.083%) (P < 0.001). We also found that elder was the risk factor for endophthalmitis following ocular surgery.In conclusion, propofol-based TIVA or inhalation anesthesia did not increase the risk of endophthalmitis after ocular surgery. Thus, GA was not a risk factor for postoperative endophthalmitis. By contrast, elder was the risk factor for postoperative endophthalmitis.

摘要

既往研究表明,全身麻醉(GA)下的患者在眼科手术结束时面部会有鼻咽分泌物,尤其是在丙泊酚全静脉麻醉(TIVA)中,这可能会诱发术后眼内炎。因此,我们进行了一项回顾性研究,以比较2011年至2015年在我们医疗中心接受局部麻醉、吸入麻醉和丙泊酚TIVA的眼科手术后眼内炎的发生率。共纳入21032例患者,我们评估了这些患者的流行病学因素、全身疾病、其他眼部病理特征、手术期间的并发症、眼科手术技术、抗生素预防方法、玻璃体培养和视力结果。在21032例手术中报告了15例眼内炎病例,发生率为0.071%。局部麻醉、吸入麻醉和丙泊酚TIVA下的发生率分别为0.083%、0.039%和0%(P = 0.39)。此外,GA下眼内炎的风险(0.024%)显著低于局部麻醉(0.083%)(P < 0.001)。我们还发现年龄较大是眼科手术后眼内炎的危险因素。总之,丙泊酚TIVA或吸入麻醉不会增加眼科手术后眼内炎的风险。因此,GA不是术后眼内炎的危险因素。相比之下,年龄较大是术后眼内炎的危险因素。

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