Gouveia Bárbara, Ferreira Leonardo, Maia Paula
Department of Anesthesiology, Centro Hospitalar Universitário de São João, Porto, Portugal.
Anesthesiol Res Pract. 2022 Mar 28;2022:3838222. doi: 10.1155/2022/3838222. eCollection 2022.
Vitrectomy is one of the most common outpatient ophthalmic surgeries. The anesthetic technique used in outpatient surgery should contribute to a faster functional recovery, better pain control, and fewer complications. The aim of this study was to compare peribulbar block and balanced general anesthesia, in patients undergoing outpatient vitrectomy.
A prospective cohort study was carried out, including adult patients undergoing ambulatory vitrectomy, between January and February 2018. Peribulbar block or balanced general anesthesia was the independent variable analyzed. Clinical and perioperative variables were evaluated, namely, postoperative pain, nausea, and vomiting in the postoperative period, intraoperative hypotension, patient satisfaction with the anesthetic technique, time to oral diet introduction and to hospital discharge, operating room occupancy time, and pharmacological costs. SPSS 27 was used for statistical analyses.
Twenty-one patients were evaluated, 11 of whom underwent peribulbar block and 10 underwent balanced general anesthesia. Patients undergoing peribulbar block did not experience postoperative pain when compared to patients undergoing balanced general anesthesia (=0.001). Intraoperative hypotension occurred in 18.2% of patients undergoing peribulbar block and in 70% of those undergoing balanced general anesthesia (=0.03). Time to oral diet introduction (<1 hour vs. > 2 hours; < 0.05), operating room occupancy time (70 vs. 90 minutes; =0.027), time to hospital discharge (17 vs. 22.5 hours; =0.004), and pharmacological costs (4.65 vs. 12.09 euros; < 0.05) were lower in patients undergoing peribulbar block versus balanced general.
Peribulbar block seems to meet the criteria of an ideal anesthetic technique in outpatient vitrectomy surgery.
玻璃体切除术是最常见的眼科门诊手术之一。门诊手术中使用的麻醉技术应有助于更快的功能恢复、更好的疼痛控制和更少的并发症。本研究的目的是比较门诊玻璃体切除术患者球周阻滞和平衡全身麻醉的效果。
进行了一项前瞻性队列研究，纳入了2018年1月至2月期间接受门诊玻璃体切除术的成年患者。分析的自变量为球周阻滞或平衡全身麻醉。评估了临床和围手术期变量，即术后疼痛、恶心和呕吐、术中低血压、患者对麻醉技术的满意度、开始经口饮食的时间和出院时间、手术室占用时间以及药物成本。使用SPSS 27进行统计分析。
共评估了21例患者，其中11例接受球周阻滞，10例接受平衡全身麻醉。与接受平衡全身麻醉的患者相比，接受球周阻滞的患者术后未出现疼痛（=0.001）。接受球周阻滞的患者中有18.2%发生术中低血压，接受平衡全身麻醉的患者中有70%发生术中低血压（=0.03）。接受球周阻滞的患者开始经口饮食的时间（<1小时 vs. >2小时；<0.05）、手术室占用时间（70 vs. 90分钟；=0.027）、出院时间（17 vs. 22.5小时；=0.004）和药物成本（4.65 vs. 12.09欧元；<0.05）均低于接受平衡全身麻醉的患者。
球周阻滞似乎符合门诊玻璃体切除手术理想麻醉技术的标准。
