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非眼科手术全身麻醉患者的暴露性角膜病变及其相关危险因素

Exposure keratopathy and its associated risk factors in patients undergoing general anesthesia in nonocular surgeries.

作者信息

Amini Nazanin, Rezaei Korosh, Modir Hesameddin, Majd Rezvan Kazemi, Graminejad Neda, Rafiei Fatemeh, Rezaei Reza, Davoodabady Zohreh, Bayati Akram

机构信息

Department of Paramedicine, Arak University of Medical Sciences, Arak, Iran.

Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.

出版信息

Oman J Ophthalmol. 2022 Jun 29;15(2):175-181. doi: 10.4103/ojo.ojo_81_21. eCollection 2022 May-Aug.

Abstract

INTRODUCTION

The most common eye injury during and after general anesthesia is corneal abrasion which can occur at any time after anesthesia and even up to 24 h after it. The aim of this study was to investigate the incidence and factors associated with corneal injury in patients undergoing nonocular surgery.

METHODS

This was a descriptive cross-sectional study. A total of 170 patients, who were admitted to the operating room and met the inclusion criteria, were selected through simple nonprobability sampling. Data collection forms were used in order to assess the incidence of corneal injury and its related risk factors. The National Eye Institute scale with fluorescein paper and cobalt blue light by slit lamp were utilized to examine exposure keratopathy.

RESULTS

Overall, the results showed that the incidence of keratopathy immediately after eye care removal was found to be 64.7% in the operating room, 65.9% in the recovery room, and 41.2% in 24 h after the surgery. Smokers' patients and drug abusers under general anesthesia underwent endotracheal intubation, received more opioids preoperatively, and had more perioperative bleeding and fluid intake. Moreover, in patients who had received more oxygen flow in the recovery room; the rate of keratopathy was higher.

CONCLUSION

Smoking, drug usage, and receiving endotracheal intubation are the risk factors of keratopathy. Therefore, for high-risk patients and procedures, it is indispensable to both obtain preoperative information and take intraoperative precautions in order to prevent eye injuries. Future studies are needed to demonstrate these finding.

摘要

引言

全身麻醉期间及之后最常见的眼部损伤是角膜擦伤,其可在麻醉后的任何时间发生,甚至在麻醉后24小时内。本研究的目的是调查接受非眼科手术患者角膜损伤的发生率及相关因素。

方法

这是一项描述性横断面研究。通过简单非概率抽样选择了总共170名入住手术室且符合纳入标准的患者。使用数据收集表来评估角膜损伤的发生率及其相关危险因素。利用荧光素纸和裂隙灯的钴蓝光采用美国国立眼科研究所量表检查暴露性角膜病变。

结果

总体而言,结果显示,在手术室中,眼部护理移除后立即发生角膜病变的发生率为64.7%,在恢复室中为65.9%,在术后24小时内为41.2%。全身麻醉下的吸烟者和药物滥用者接受气管插管,术前接受更多阿片类药物,围手术期出血和液体摄入量更多。此外,在恢复室中接受更多氧气流量的患者中,角膜病变发生率更高。

结论

吸烟、药物使用和接受气管插管是角膜病变的危险因素。因此,对于高危患者和手术,获取术前信息并采取术中预防措施以预防眼部损伤是必不可少的。需要未来的研究来证实这些发现。

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